Provider Demographics
NPI:1801658067
Name:INTERVENTIONAL PAIN INSTITUTE LLC
Entity type:Organization
Organization Name:INTERVENTIONAL PAIN INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAMIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GHEITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:636-933-2243
Mailing Address - Street 1:PO BOX 3891
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63006-3891
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 CHESTERFIELD CTR STE 250
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-4833
Practice Address - Country:US
Practice Address - Phone:636-933-2243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty