Healthcare Provider Details

I. General information

NPI: 1417936584
Provider Name (Legal Business Name): NEURO PAIN CONSULTANTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

359 ENTERPRISE CT SPC B
BLOOMFIELD HILLS MI
48302-1055
US

IV. Provider business mailing address

799 DENISON CT FL 2
BLOOMFIELD HILLS MI
48302-0053
US

V. Phone/Fax

Practice location:
  • Phone: 248-751-7246
  • Fax: 248-418-2311
Mailing address:
  • Phone: 248-751-7246
  • Fax: 248-418-2311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number4301072377
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number4301058094
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number4301063268
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number4301016093
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number4301404978
License Number StateMI
# 6
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number4301029245
License Number StateMI
# 7
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number4301070369
License Number StateMI
# 8
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number4301041666
License Number StateMI
# 9
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number4301059614
License Number StateMI
# 10
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501007831
License Number StateMI
# 11
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number5601003312
License Number StateMI
# 12
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704150069
License Number StateMI
# 13
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704178303
License Number StateMI
# 14
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number4301406392
License Number StateMI

VIII. Authorized Official

Name: TODD E LININGER
Title or Position: OWNER
Credential: M.D.
Phone: 248-751-7246