Premier Spinal Pain Management Center, PLLC

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

4301042515 Issued in MI

Legal business name

PREMIER SPINAL PAIN MANAGEMENT CENTER, PLLC

Practice address

15101 Southfield Rd
Suite 103
Allen Park, MI 48101-2697

Phone

(313) 381-1650

Fax

(313) 381-1652

NPI assigned

Dec 11, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Gayatri Garg, M.D.NPI 1689897811

Title

Owner

Phone

(313) 381-1650

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gayatri Garg, MD

  • Pediatrics Physician
  • Pontiac, MI
  • NPI 1689897811
  NPD (past) Authorized official

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

{
    "created_epoch": "1228953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252195200000",
    "number": "1649415100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15101 SOUTHFIELD RD",
            "address_2": "SUITE 103",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012697",
            "telephone_number": "313-381-1650",
            "fax_number": "313-381-1652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15101 SOUTHFIELD RD",
            "address_2": "SUITE 103",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012697",
            "telephone_number": "313-381-1650",
            "fax_number": "313-381-1652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SPINAL PAIN MANAGEMENT CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-11",
        "last_updated": "2009-09-06",
        "status": "A",
        "authorized_official_last_name": "GARG",
        "authorized_official_first_name": "GAYATRI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-381-1650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MI",
            "license": "4301042515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie Porter, PT
• Kevin Joel Potocsky, D.D.S.
• Pinnamaneni Ramakrishna Prasad, M.D.
• Precious U LLC
• Premier Integrated Healthcare Group PLLC
• Priority Health Physical Therapy & Rehabilitation
• Priority Imaging Corp
• Priority RX Pharmacy
• Purple Change Wellness Institute of Trauma Recovery and Well-Being
• Purple Change Wellness LLC

• Vascular & Interventional Radiology Physician in Allen Park, MI
• Providers in Allen Park, MI by specialty
• Vascular & Interventional Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2009; 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.