MICHIGAN PAIN&SPINE CLINIC PLLC (NPI# 1194180901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194180901 |
| Entity Type | Organization |
| Organization Name | MICHIGAN PAIN&SPINE CLINIC PLLC |
| Practice Address |
4201 Saint Antoine St Suite 6b, University Health Center Detroit MI 48201-2153 |
| Practice Telephone | 3134957200 |
| Practice Fax Number | 3134957104 |
| Mailing Telephone | 3134957200 |
| Mailing Fax Number | 3134957104 |
| Enumeration Date | 2015-12-21 |
| Last Update Date | 2015-12-21 |
| Authorized Official Name | DR. SRUTHI KONDUR (PRESIDENT) |
| Authorized Official Telephone | 3134957200 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
4301086330 | MI | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538597877 | Michigan Pain&spine Clinic Pllc | Clinic/Center | 6255 Inkster Rd Ste 105, Garden City, MI 48135-2538 | 2013-10-23 |
| Street Address |
4201 SAINT ANTOINE ST SUITE 6B, UNIVERSITY HEALTH CENTER |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760477871 | John Mckay Perkowski | Nurse Anesthetist, Certified Registered | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2005-09-14 |
| 1013517028 | Madappulli Arachchige Wickrama | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-10-28 |
| 1134731466 | Helda Bacall | Nurse Practitioner | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-08-18 |
| 1568088680 | Michelle De Varennes | Physician Assistant | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-24 |
| 1235754144 | Saren Yeranosian | Pharmacist | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-16 |
| 1083239230 | Jacqueline Ferraro-jaworski | Pharmacist | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-13 |
| 1770107617 | Zamaan Sayeed Sohel | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-06 |
| 1881218790 | Erin Marie Dinnell | Nurse Practitioner | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-05 |
| 1487276721 | Andrew R Kumar | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-05-09 |
| 1598386005 | Kayla Richelle Robinson | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-05-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
| Find all providers in zip 48201 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588274401 | Vip Medical Care | Clinic/Center | 18940 Schoolcraft, Detroit, MI 48223-2906 | 2020-08-05 |
| 1053818039 | Latonya Wallace-hardiman | Clinic/Center | 5830 Conner St, Detroit, MI 48213-3458 | 2018-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649813650 | Metro Med Pain Management & Rehab Plc | Clinic/Center | 4520 Firestone St Ste A, Dearborn, MI 48126-4602 | 2019-10-22 |
| 1295382976 | Care Recovery Clinic Pllc | Clinic/Center | 13530 Michigan Ave Ste 301, Dearborn, MI 48126-3555 | 2019-08-19 |
| 1902459860 | Comprehensive Care Pain Management, P.C. | Clinic/Center | 9001 15 Mile Rd Ste C, Sterling Heights, MI 48312-3621 | 2019-07-19 |
| 1386296077 | Michigan Institute of Musculoskeletal Medicine Pllc | Clinic/Center | 26206 W 12 Mile Rd Ste 200, Southfield, MI 48034-8500 | 2019-07-12 |
| 1740832930 | Heights Pain Management & Rehab Plc | Clinic/Center | 30671 Stephenson Hwy Ste D, Madison Heights, MI 48071-1635 | 2019-07-09 |
| 1609340215 | Michigan Orthopedic Spine & Interventionalist Pllc | Clinic/Center | 17290 Stonebrook Dr, Northville, MI 48168-4324 | 2019-01-16 |
| 1992204341 | Jawad A Shah Md PC | Clinic/Center | 4400 S Saginaw St Ste 1370, Flint, MI 48507-2668 | 2018-02-12 |
| 1508308750 | Mark Sobor, Md | Clinic/Center | 13560 76th St, Unit 2, South Haven, MI 49090-9483 | 2016-11-04 |
| 1316316771 | Advanced Rehab and Pain Management PC | Clinic/Center | 1820 Oak Ave, Muskegon, MI 49442-2408 | 2015-09-16 |
| 1154717106 | Excellent Pain Consultants | Clinic/Center | 15565 Northland Dr W Ste 304, Southfield, MI 48075-5313 | 2015-04-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.