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General NPI Number Information
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NPI Number | 1831491851
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Entity Type | Organization
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Legal Business Name | ANA PAIN MANAGEMENT PC
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Dates
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Enumeration Date | 11/23/2010
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Last Update Date | 03/05/2021
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Provider Practice Location Address
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Address Line | 42645 GARFIELD RD STE 103
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-5022
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Country | US
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Telephone | 586-286-7246
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Fax | 586-329-4751
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Provider Business Mailing Address
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Address Line | 42645 GARFIELD RD STE 103
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-5022
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Country | US
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Telephone | 586-286-7246
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Fax | 586-329-4751
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Authorized Official
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Title or Position | OWNER
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Name | ANAND CHANDRA THAKUR
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Credential | MD
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Telephone | 586-286-7246
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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 | 4301093287
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License Number State | MI
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