NPI 1568889442

Blue Water Pain Specialists PC

Organisation Pain Medicine Physician Detroit, MI

Practice location

Address: 22101 Moross Rd, Detroit, MI 48236-2148
Phone: (313) 343-4000
Mailing address: 538 Chase Ln, Bloomfield Hills, MI 48304-2363

Authorised official

Name: Bassam E. Durgham
Title: Treasurer
Phone: (248) 792-7029

Registered specialties

Pain Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208VP0000X

Other Pain Medicine providers in Michigan →

Registry record

NPI: 1568889442
Entity type: Organization
NPI issued: 28 Mar 2014
Record last updated: 15 Nov 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.