MEDICARE: COMPREHENSIVE SPINE AND PAIN MANAGEMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP3300X	Pain Clinic/Center	C10006663	DE

General Provider Information

NPI Number	:	1043652902
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE SPINE AND PAIN MANAGEMENT

Provider Business Mailing Address
First Line	:	PO BOX 5805
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19808-0805
Country	:	US
Telephone Number	:	302-463-4704
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 STANTON CHRISTIANA RD STE 303
Second Line	:
City	:	NEWARK
State	:	DE
Zip	:	19713-2125
Country	:	US
Telephone Number	:	302-463-4704
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. ASIT PRAVIN PATEL
Credential	:	M.D.
Telephone Number	:	302-463-4704

Provider Enumeration Date	:	07/20/2013
Last Update Date	:	07/20/2013

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Directions to “COMPREHENSIVE SPINE AND PAIN MANAGEMENT ” Practice Location

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