Provider Demographics
NPI:1366713786
Name:COMPREHENSIVE CHRONIC PAIN MANAGEMENT PLC
Entity type:Organization
Organization Name:COMPREHENSIVE CHRONIC PAIN MANAGEMENT PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAWFIQ
Authorized Official - Middle Name:E
Authorized Official - Last Name:NAKHLEH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:586-286-0639
Mailing Address - Street 1:43171 DALCOMA DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-6307
Mailing Address - Country:US
Mailing Address - Phone:586-286-0639
Mailing Address - Fax:586-286-0657
Practice Address - Street 1:43171 DALCOMA DR
Practice Address - Street 2:SUITE 3
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-6307
Practice Address - Country:US
Practice Address - Phone:586-286-0639
Practice Address - Fax:586-286-0657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIF42239Medicare UPIN