Provider Demographics
NPI:1750435905
Name:THE PAIN MANAGEMENT CLINIC LLC
Entity type:Organization
Organization Name:THE PAIN MANAGEMENT CLINIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:SAYEGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-435-8484
Mailing Address - Street 1:1175 S 13TH ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-3059
Mailing Address - Country:US
Mailing Address - Phone:740-435-8484
Mailing Address - Fax:740-432-2528
Practice Address - Street 1:1175 S 13TH ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-3059
Practice Address - Country:US
Practice Address - Phone:740-435-8484
Practice Address - Fax:740-432-2528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35085692207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH6637030001Medicare NSC