Provider Demographics
NPI:1811300155
Name:NEUROLOGY & PAIN INSTITUTE PLLC
Entity type:Organization
Organization Name:NEUROLOGY & PAIN INSTITUTE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:MARWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUAYTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-989-6880
Mailing Address - Street 1:1103 7TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060
Mailing Address - Country:US
Mailing Address - Phone:810-990-6880
Mailing Address - Fax:810-990-6881
Practice Address - Street 1:1103 7TH ST STE C
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-5497
Practice Address - Country:US
Practice Address - Phone:810-990-6880
Practice Address - Fax:810-990-6881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-04
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Single Specialty