# ST CLAIR PAIN CONSULTANTS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801347398
- **Authorized official:** DR. JOHN G GHANEM M.D. (PRESIDENT)
- **Authorized official phone:** (313) 580-0015

## Contact information

- **Practice address:** 29751 LITTLE MACK AVE, SUITE A, ROSEVILLE, MI 48066-6503
- **Practice address phone:** (313) 580-0015
- **Practice address fax:** (313) 884-6313
- **Mailing address:** 432 S WASHINGTON AVE, UNIT 1101, ROYAL OAK, MI 48067-3854
- **Mailing address phone:** (313) 580-0015
- **Mailing address fax:** (313) 884-6313

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | — |
| 207L00000X | Anesthesiology Physician | — | — | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/19/2016
- **Last updated:** 10/19/2016