Healthcare Provider Details

I. General information

NPI: 1386982635
Provider Name (Legal Business Name): NEW HORIZON PAIN MANAGEMENT PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2013
Last Update Date: 11/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39640 DORIAN DR
STERLING HEIGHTS MI
48310-2311
US

IV. Provider business mailing address

39640 DORIAN DR
STERLING HEIGHTS MI
48310-2311
US

V. Phone/Fax

Practice location:
  • Phone: 586-726-4900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MIKE TOOMA
Title or Position: MANAGER
Credential:
Phone: 586-726-4900