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General NPI Number Information
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NPI Number | 1679783948
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Entity Type | Organization
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Legal Business Name | CONSULT CARE PAIN MEDICINE P A.
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 09/27/2011
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Provider Practice Location Address
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Address Line | 501 AIRPORT RD
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City | PANAMA CITY
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State | FL
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Zip | 32405-4010
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Country | US
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Telephone | 850-913-9488
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Fax | 850-522-9443
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Provider Business Mailing Address
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Address Line | P.O. BOX 15547
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City | PANAMA CITY
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State | FL
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Zip | 32401
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Country | US
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Telephone | 850-913-9488
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Fax | 850-522-9443
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Authorized Official
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Title or Position | M.D OWNER
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Name | DR. ATA UL MOHSIN
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Credential | M.D.
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Telephone | 850-913-9488
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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 | ME87428
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License Number State | FL
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