Organization
INTERVENTIONAL PAIN MANAGEMENT SERVICES LLC
Active
Other names
INTERVENTIONAL PAIN MANAGEMENT, Interventional Pain Management Services
Organization subpart
No
Provider details
NPI number
Authorized official
MAHENDRA GUNAPOOTI MD (PRESIDENT)
(314) 830-2600
Entity
Organization
Contact information
Practice address
2421 CORPORATE CTR STE 105, GRANITE CITY, IL 62040-4195
(618) 288-8905
Mailing address
PO BOX 650, EDWARDSVILLE, IL 62025-0650
(314) 830-2600
(314) 830-2648
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/02/2018
Last updated
05/06/2026
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