Provider Demographics
NPI:1801050083
Name:MICHIGAN PAIN CLINIC ASSOCIATES PC
Entity type:Organization
Organization Name:MICHIGAN PAIN CLINIC ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAKESH
Authorized Official - Middle Name:
Authorized Official - Last Name:VAKHARIYA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:586-977-7246
Mailing Address - Street 1:5456 15 MILE RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-5110
Mailing Address - Country:US
Mailing Address - Phone:586-978-7250
Mailing Address - Fax:
Practice Address - Street 1:5456 15 MILE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-5110
Practice Address - Country:US
Practice Address - Phone:586-977-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301087912207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty