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General NPI Number Information
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NPI Number | 1134093214
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Entity Type | Organization
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Legal Business Name | REGENERATIVE PAIN & SPINE OF INDIANA PC
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Dates
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Enumeration Date | 10/02/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 7725 BROADWAY
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City | MERRILLVILLE
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State | IN
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Zip | 46410-4731
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Country | US
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Telephone | 312-300-3882
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Fax |
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Provider Business Mailing Address
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Address Line | 7725 BROADWAY
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City | MERRILLVILLE
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State | IN
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Zip | 46410-4731
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHOEB MOHIUDDIN
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Credential | MD
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Telephone | 312-300-3882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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