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General NPI Number Information
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NPI Number | 1487972766
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Entity Type | Organization
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Legal Business Name | AMERICAN PAIN & SPINE CENTER, P.C.
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Dates
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Enumeration Date | 05/11/2010
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 3845 MONROE ST
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City | DEARBORN
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State | MI
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Zip | 48124-4607
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Country | US
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Telephone | 313-586-4030
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Fax | 313-586-4031
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Provider Business Mailing Address
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Address Line | 3845 MONROE ST
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City | DEARBORN
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State | MI
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Zip | 48124-4607
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Country | US
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Telephone | 313-586-4030
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Fax | 313-586-4031
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. WALID AREF OSTA
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Credential | MD
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Telephone | 313-586-4030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 4301085721
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License Number State | MI
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