The Pain Center USA PLLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

4301033013 Issued in MI

Legal business name

THE PAIN CENTER USA PLLC

Practice address

27423 Van Dyke Ave
Warren, MI 48093-2867

Phone

(586) 755-9855

Fax

(586) 755-9880

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Rajendra Bothra, MD

Title

Owner

Phone

(586) 755-9855

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188259200000",
    "number": "1508996653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27423 VAN DYKE AVE",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932867",
            "telephone_number": "586-755-9855",
            "fax_number": "586-755-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27423 VAN DYKE AVE",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932867",
            "telephone_number": "586-755-9855",
            "fax_number": "586-755-9880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PAIN CENTER USA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-08-28",
        "status": "A",
        "authorized_official_last_name": "BOTHRA",
        "authorized_official_first_name": "RAJENDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-755-9855",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MI",
            "license": "4301033013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Interventional Pain Medicine Physician in Warren, MI
• Providers in Warren, MI by specialty
• Interventional Pain Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; 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.