PAIN MANAGEMENT SPECIALISTS LLC NPI 1881693562

NPI Information

NPI: 1881693562
Provider Name: PAIN MANAGEMENT SPECIALISTS LLC
Classification: Clinic/Center - 261QP3300X
Entity Type: Organization

Specialization: Pain

Address:
8840 CALUMET AVE
SUITE 103
MUNSTER, IN
ZIP 46321
Phone: (219) 836-7246
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PAIN MANAGEMENT SPECIALISTS LLC is a pain clinic center in Munster, IN. PAIN MANAGEMENT SPECIALISTS LLC NPI is 1881693562. The provider is registered as an organization entity type.

The provider's business location address is:

8840 CALUMET AVE
SUITE 103
MUNSTER, IN
ZIP 46321-037
Phone: (219) 836-7246
Fax: (219) 836-6454

The provider's authorized official is Shanu Kondamuri .
The authorized official title is Medical Director and has the following contact phone number (219) 836-7246.

The enumeration date for this NPI number is 7/15/2005 and was last updated on 12/15/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP3300X	Clinic/Center	Pain		INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DE2009	OTHER	GEORGIA	RAILROAD MEDICARE
2	90001240	OTHER	INDIANA	BCBS IL
3	000000388635	OTHER	INDIANA	ANTHEM
4	200531330A	MEDICAID	INDIANA
5	232400	MEDICARE ID-TYPE UNSPECIFIED	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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