Provider Demographics
NPI:1588143226
Name:AFFILIATED PAIN MANAGEMENT LLC
Entity type:Organization
Organization Name:AFFILIATED PAIN MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIMURO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:775-600-7247
Mailing Address - Street 1:2080 E CALVADA BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-6578
Mailing Address - Country:US
Mailing Address - Phone:775-600-7247
Mailing Address - Fax:775-537-2090
Practice Address - Street 1:2080 E CALVADA BLVD STE 500
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-6578
Practice Address - Country:US
Practice Address - Phone:775-600-7247
Practice Address - Fax:775-537-2090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVD01392207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty