MEDICARE: CENTER FOR PAIN MANAGEMENT LLC

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	207LP2900X	Pain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number	:	1740204262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR PAIN MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	980 CHESTER BLVD
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-2317
Country	:	US
Telephone Number	:	765-983-3410
Fax Number	:	765-983-3045

Provider Business Practice Location Address
First Line	:	980 CHESTER BLVD
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-2317
Country	:	US
Telephone Number	:	765-983-3410
Fax Number	:	765-983-3045

Authorized Official
Title or Position	:	PRESIDENT
Name	:	VISH BRAHMBHATT
Credential	:	MD
Telephone Number	:	765-983-3410

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	11/26/2018

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Directions to “CENTER FOR PAIN MANAGEMENT LLC ” Practice Location

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