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Organization

EAST WEST PAIN INSTITUTE, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SHUSHOVAN CHAKRABORTTY MD (PRESIDENT)
(248) 709-2526
Entity
Organization

Contact information

Practice address
425 N PARK BLVD, SUITE 201, LAKE ORION, MI 48362-3189
(248) 709-2526
Mailing address
425 N PARK BLVD, SUITE 201, LAKE ORION, MI 48362-3189
(248) 709-2526

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary

Other

Enumeration date
09/22/2015
Last updated
09/29/2015
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