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General NPI Number Information
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NPI Number | 1720643893
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Entity Type | Organization
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Legal Business Name | MIDWEST MULTISPECIALTY INSTITUTE PLLC
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Dates
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Enumeration Date | 05/04/2019
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Last Update Date | 01/31/2020
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Provider Practice Location Address
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Address Line | 31700 VAN DYKE AVE
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City | WARREN
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State | MI
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Zip | 48093-7949
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Country | US
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Telephone | 586-333-5365
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Fax |
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Provider Business Mailing Address
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Address Line | 31700 VAN DYKE AVE
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City | WARREN
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State | MI
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Zip | 48093-7949
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Country | US
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Telephone | 586-333-5365
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Fax |
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Authorized Official
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Title or Position | C.E.O
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Name | DR. JEAN R PIERRE-PAUL SR.
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Credential | MD
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Telephone | 586-382-9655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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