Healthcare Provider Details

I. General information

NPI: 1457387078
Provider Name (Legal Business Name): ADVANCED PAIN AND ANESTHESIA CONSULTANTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 08/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11456 BROADWAY
CROWN POINT IN
46307-7106
US

IV. Provider business mailing address

11456 BROADWAY
CROWN POINT IN
46307-7106
US

V. Phone/Fax

Practice location:
  • Phone: 219-488-0176
  • Fax: 219-661-1408
Mailing address:
  • Phone: 219-488-0156
  • Fax: 219-661-1408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. FAISAL M. RAHMAN
Title or Position: CEO
Credential: PH.D.
Phone: 219-488-0176