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Organization
MILLENIUM PAIN MANAGEMENT & THERAPY
Active
Organization
MILLENIUM PAIN MANAGEMENT & THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORAM O MOGAKA MD (CEO)
(586) 777-0630
Entity
Organization
Contact information
Practice address
21409 KELLY RD, STE 400, EASTPOINTE, MI 48021-3264
(586) 777-0630
Mailing address
PO BOX 2666, FARMINGTON HILLS, MI 48333-2666
(586) 777-0630
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
NULL
208VP0000X
Pain Medicine Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
11/08/2011
Last updated
11/08/2011
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