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General NPI Number Information
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NPI Number | 1255877171
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Entity Type | Organization
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Legal Business Name | INTERVENTIONAL PAIN CENTER, PLLC
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Dates
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Enumeration Date | 01/17/2017
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 123 SUNNYBROOK RD SUITE 130
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City | RALEIGH
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State | NC
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Zip | 27610-2783
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Country | US
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Telephone | 984-200-5318
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Fax | 984-200-5321
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Provider Business Mailing Address
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Address Line | PO BOX 931038
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City | ATLANTA
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State | GA
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Zip | 31193-1038
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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 | PHYSICIAN OWNER
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Name | VIREN DINKERRAI DESAI
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Credential | MD
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Telephone | 910-321-7246
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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 | 200100673
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License Number State | NC
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