Organization
MILAN BEHAVIORAL AND PAIN SOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE OWEN DIAZ (ADMINISTRATOR)
(734) 645-7289
Entity
Organization
Contact information
Practice address
3 E MAIN ST, SUITE C, MILAN, MI 48160-1248
(734) 439-7480
(734) 439-1384
Mailing address
3 E MAIN ST, SUITE C, MILAN, MI 48160-1248
(734) 439-7480
(734) 439-1384
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
4301035476
MI
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
Primary
4301035476
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0817222
BCBSM
—
01
—
1801941281
NPI
MI
Enumeration date
10/21/2009
Last updated
10/21/2009
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