Michigan Pain&Spine Clinic PLLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

4301086330 Issued in MI

Legal business name

MICHIGAN PAIN&SPINE CLINIC PLLC

Practice address

4201 Saint Antoine St
Suite 6B, University Health Center
Detroit, MI 48201-2153

Phone

(313) 495-7200

Fax

(313) 495-7104

NPI assigned

Dec 21, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Sruthi Kondur, MD

Title

President

Phone

(313) 495-7200

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450656000000",
    "number": "1194180901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "address_2": "SUITE 6B, UNIVERSITY HEALTH CENTER",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-495-7200",
            "fax_number": "313-495-7104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "address_2": "SUITE 6B, UNIVERSITY HEALTH CENTER",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-495-7200",
            "fax_number": "313-495-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN PAIN&SPINE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-21",
        "last_updated": "2015-12-21",
        "status": "A",
        "authorized_official_last_name": "KONDUR",
        "authorized_official_first_name": "SRUTHI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-495-7200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "MI",
            "license": "4301086330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michigan Infection Specialists PLLC
• Michigan Institute for Prevention and Intervention
• Michigan Magical
• Michigan Medical Mall
• Michigan Medical Specialists PC
• Michigan Pediatric Cardiovascular Surgeons PC
• Michigan Pediatric Surgery Associates P.C.
• Michigan Physical Therapy
• Michigan Providers LLC
• Michigan Recovery and Wellness Initive

• Pain Clinic/Center in Detroit, MI
• Providers in Detroit, MI by specialty
• Pain Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.