# ADVANCED INTERVENTIONAL PAIN MANAGEMENT, PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1982669339
- **Authorized official:** MRS. JOHNETTE CAROL SHULTZ (CFO, PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (336) 714-6406

## Contact information

- **Practice address:** 160 KIMEL FOREST DR, SUITE100, WINSTON SALEM, NC 27103-6074
- **Practice address phone:** (336) 714-6400
- **Practice address fax:** (336) 714-6402
- **Mailing address:** 160 KIMEL FOREST DR, SUITE 100, WINSTON SALEM, NC 27103-6074
- **Mailing address phone:** (336) 714-6400
- **Mailing address fax:** (336) 714-6402

## Taxonomy

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

## Other

- **Enumeration date:** 04/19/2006
- **Last updated:** 01/06/2010