Provider Demographics
NPI:1437441292
Name:COMPREHENSIVE PAIN & SPINE ASSOCIATES, PLLC
Entity type:Organization
Organization Name:COMPREHENSIVE PAIN & SPINE ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BERLINER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:704-941-9669
Mailing Address - Street 1:8035 PROVIDENCE RD
Mailing Address - Street 2:340
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-9716
Mailing Address - Country:US
Mailing Address - Phone:704-542-3988
Mailing Address - Fax:
Practice Address - Street 1:8035 PROVIDENCE RD
Practice Address - Street 2:340
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-9716
Practice Address - Country:US
Practice Address - Phone:704-542-3988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-11
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201001017208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6627410001Medicare NSC