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General NPI Number Information
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NPI Number | 1811033822
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Entity Type | Organization
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Legal Business Name | SUMTER INTERVENTIONAL PAIN ASSOCIATES
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 11/15/2007
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Provider Practice Location Address
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Address Line | 764 W LIBERTY ST STE 3
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City | SUMTER
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State | SC
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Zip | 29150-4770
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Country | US
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Telephone | 803-774-2570
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Fax | 803-774-2571
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Provider Business Mailing Address
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Address Line | 764 W LIBERTY ST STE 3
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City | SUMTER
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State | SC
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Zip | 29150-4770
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Country | US
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Telephone | 803-774-2570
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Fax | 803-774-2571
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Authorized Official
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Title or Position | M.D.
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Name | KAMRAN Z KORANLOO
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Credential | M.D.
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Telephone | 803-774-2570
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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 | 23150
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License Number State | SC
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