Provider Demographics
NPI:1801949037
Name:RICHMOND SPINE INTERVENTIONS AND PAIN CENTER, PC
Entity type:Organization
Organization Name:RICHMOND SPINE INTERVENTIONS AND PAIN CENTER, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PEYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAZMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-426-4422
Mailing Address - Street 1:3420 PUMP RD # 160
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1111
Mailing Address - Country:US
Mailing Address - Phone:804-378-1800
Mailing Address - Fax:
Practice Address - Street 1:14404 SOMMERVILLE CT
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-6835
Practice Address - Country:US
Practice Address - Phone:804-378-1800
Practice Address - Fax:804-378-5400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052340174400000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09502Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER