Organization
PHYSICIANS PAIN AND SPINE SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAWN X WU MD (MEDICAL DIRECTOR)
(248) 342-5207
Entity
Organization
Contact information
Practice address
14986 ANGELA DR, GULFPORT, MS 39503-3502
(228) 357-5464
(877) 563-0603
Mailing address
14986 ANGELA DR, GULFPORT, MS 39503-3502
(228) 357-5464
(877) 563-0603
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
18988
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05482375
—
MS
Enumeration date
01/23/2013
Last updated
01/18/2021
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