Healthcare Provider Details

I. General information

NPI: 1326213364
Provider Name (Legal Business Name): SOUTHWEST OHIO PAIN INSTITUTE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7760 W VOICE OF AMERICA PARK DR SUITE D
WEST CHESTER OH
45069-3371
US

IV. Provider business mailing address

6576 ROSEWOOD LN
MASON OH
45040-5924
US

V. Phone/Fax

Practice location:
  • Phone: 513-860-0371
  • Fax:
Mailing address:
  • Phone: 513-967-0566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MUHAMMAD A MUNIR
Title or Position: PRESIDENT
Credential: MD
Phone: 513-967-0566