Midwest Interventional Spine Specialists,Llc

LBN: Midwest Pain Management Centers,Llc
Midwest Interventional Spine Specialists,Llc is an health care organization with primary practice located at 8840 Calumet Ave Suite 103, Munster IN 46321-2529. The organization recently has only one registered license in Ambulatory Health Care Facilities / Pain, which is considered as the primary health care specialty. Midwest Pain Management Centers,Llc can be contacted via phone (219) 836-7246, or through Kondamuri, Shanu via phone (219) 836-7246.

Contact Information

Primary practice address
8840 Calumet Ave Suite 103 Munster IN 46321-2529
Fax: (219) 836-6454
Website:
Authorized official contact:
Name: Kondamuri, Shanu Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Pain 261QP3300X Indiana

Profile Details

NPI number 1962401745
LBN Legal business name Midwest Pain Management Centers,Llc
DBA Doing business as Midwest Interventional Spine Specialists,Llc
Authorized official Kondamuri, Shanu Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 14th, 2005
Last updated Mar 24th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962401745 NPPES
Indiana MEDICAID 200095110A
Indiana Other CE8846
Indiana Other 90001076

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