Michiana Spine, Sports & Occupational Rehab, Pc in Mishawaka - Pain Medicine
Michiana Spine, Sports & Occupational Rehab, Pc - NPI 1912074659
Michiana Spine, Sports & Occupational Rehab, Pc is a Pain Medicine in Mishawaka, Indiana. Michiana Spine, Sports & Occupational Rehab, Pc practices all healthcare services and medical treatments related to Pain Medicine. The NPI Number for Michiana Spine, Sports & Occupational Rehab, Pc is 1912074659. The last update date is 2022-11-03.
Michiana Spine, Sports & Occupational Rehab, Pc's current location address is 3740 Edison Lakes Pkwy, Mishawaka, Indiana. You can contact this provider via phone number 5742524150 and fax number 5742524159. The mailing address for Michiana Spine, Sports & Occupational Rehab, Pc is 3740 Edison Lakes Pkwy, Mishawaka, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Michiana Spine, Sports & Occupational Rehab, Pc |
|---|---|
| Address | 3740 Edison Lakes Pkwy, Mishawaka, Indiana |
| Phone Number | 5742524150 |
| Fax Number | 5742524159 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Drew Gene Kevin |
| Credentials | M.D. |
| Telephone Number | 5742524150 |
NPI Number Detail
| NPI Number | 1912074659 |
|---|---|
| Provider Enumeration Date | 2006-11-29 |
| Last Updated Date | 2022-11-03 |
Provider Mailing Address Detail
| Address | 3740 Edison Lakes Pkwy |
|---|---|
| City | Mishawaka |
| State | Indiana (IN) |
| Post Code | 465453474 |
| Phone Number | 5742524150 |
| Fax Number | 5742524159 |
Provider's Primary Taxonomy Detail
| Speciality | Pain Medicine |
|---|---|
| Taxonomy | 2081P2900X |
| Licence No | 1042863 |
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Definition: A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated wit |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| CI5205 | RAILROAD MEDICARE | ||
| 129646400 | DEPT OF LABORACS | ||
| 200216220A | IN | -- | |
| 25-0A110370 | MI | BCBSMI |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Michiana Spine, Sports & Occupational Rehab, Pc by the Centers for Medicare & Medicaid Services?
The Michiana Spine, Sports & Occupational Rehab, Pc has been assigned the NPI (National Provider Identifier) 1912074659 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you share the physical location details of Michiana Spine, Sports & Occupational Rehab, Pc?
The Michiana Spine, Sports & Occupational Rehab, Pc is situated at 3740 Edison Lakes Pkwy, in the city of Mishawaka, state of IN, with the zip code 465453474.
What is Michiana Spine, Sports & Occupational Rehab, Pc's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Michiana Spine, Sports & Occupational Rehab, Pc is Pain Medicine, and the taxonomy code that classifies this field of practice is 2081P2900X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1912074659 to Michiana Spine, Sports & Occupational Rehab, Pc?
The Centers for Medicare & Medicaid Services originally issued the 1912074659 to Michiana Spine, Sports & Occupational Rehab, Pc on 2006-11-29.
When was the information regarding Michiana Spine, Sports & Occupational Rehab, Pc most recently updated?
The details pertaining to the Michiana Spine, Sports & Occupational Rehab, Pc, including its address, specialty, and other relevant information, were last refreshed on 2022-11-03.