Organization
PAIN MANAGEMENT ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE S HUMPHREY (PRACTICE ADMINISTRATOR)
(704) 864-8772
Entity
Organization
Contact information
Practice address
640 SUMMITT XING PL, SUITE 200, GASTONIA, NC 28054-2138
(704) 671-5400
Mailing address
PO BOX 12845, GASTONIA, NC 28052-0017
(704) 864-8772
(704) 866-7853
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0278G
NC BCBS
NC
05
—
890278G
—
NC
01
—
CE8260
RAILROAD MEDICARE
NC
Enumeration date
05/26/2006
Last updated
12/07/2007
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