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Organization
PAIN PHYSICIANS OF INDIANA PC
Active
Organization
PAIN PHYSICIANS OF INDIANA PC
Active
Other names
Interventional Pain Consultants
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAREK HASSAN SHAHBANDAR M.D. (CEO/PRESIDENT)
(219) 750-9630
Entity
Organization
Contact information
Practice address
8687 CONNECTICUT ST, STE D, MERRILLVILLE, IN 46410-5541
(219) 750-9630
(219) 750-9451
Mailing address
PO BOX 10685, MERRILLVILLE, IN 46411-0685
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201066350A
—
IN
Enumeration date
04/04/2012
Last updated
10/20/2015
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