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NPI Code Detail

MEDICARE: MICHIGAN INSTITUTE OF PAIN MANAGEMENT WEST

MEDICARE: MICHIGAN INSTITUTE OF PAIN MANAGEMENT WEST
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
1208VP0000XPain Medicine Physician

General Provider Information

NPI Number : 1598081317
Entity Type Code : Organization
Provider Name (Legal Business Name) : MICHIGAN INSTITUTE OF PAIN MANAGEMENT WEST
Provider Business Mailing Address
First Line : PO BOX 1665
Second Line :
City : BELLEVILLE
State : MI
Zip : 48112-1665
Country : US
Telephone Number : 313-565-6782
Fax Number : 313-565-6784
Provider Business Practice Location Address
First Line : 11650 BELLEVILLE ROAD
Second Line :
City : VAN BUREN TOWNSHIP
State : MI
Zip : 48111
Country : US
Telephone Number : 313-565-6782
Fax Number : 313-565-6784
Authorized Official
Title or Position : PHYSICIAN
Name : HUSSEIN ABDURAHMAN HURAIBI
Credential : M.D.
Telephone Number : 313-565-6782
Provider Enumeration Date : 04/19/2010
Last Update Date : 04/19/2010

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Directions to “MICHIGAN INSTITUTE OF PAIN MANAGEMENT WEST ” Practice Location

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