Organization
PAIN PHYSICIANS OF INDIANA PC
Active
Other names
Interventional Pain Consultants
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAREK HASSAN SHAHBANDAR M.D. (CEO/PRESIDENT)
(219) 750-9630
Entity
Organization
Contact information
Practice address
8687 CONNECTICUT ST, STE D, MERRILLVILLE, IN 46410-5541
(219) 750-9630
(219) 750-9451
Mailing address
PO BOX 10685, MERRILLVILLE, IN 46411-0685
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201066350A
—
IN
Enumeration date
04/04/2012
Last updated
10/20/2015
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