Organization
PAIN MANAGEMENT SOLUTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY S. MASIMORE MD (AUTHORIZED OFFICIAL)
(317) 346-7246
Entity
Organization
Contact information
Practice address
730 EXECUTIVE PARK DR STE A, GREENWOOD, IN 46143-3213
(317) 346-7246
(317) 543-3763
Mailing address
730 EXECUTIVE PARK DR STE A, GREENWOOD, IN 46143-3213
(317) 346-7246
(317) 543-3763
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200997010A
—
IN
05
—
200997010C
—
IN
Enumeration date
09/09/2010
Last updated
02/27/2019
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