Provider Demographics
NPI:1962435636
Name:INVASIVE PAIN CONSULTANTS
Entity type:Organization
Organization Name:INVASIVE PAIN CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:NEMEC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-855-3488
Mailing Address - Street 1:400 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:WACONIA
Mailing Address - State:MN
Mailing Address - Zip Code:55387-4552
Mailing Address - Country:US
Mailing Address - Phone:952-442-9770
Mailing Address - Fax:952-442-3630
Practice Address - Street 1:4519 BRAMBLETON AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-3436
Practice Address - Country:US
Practice Address - Phone:540-855-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA239315OtherSOUTHERN HEALTH
VA139652OtherBLUE CROSS OF VA
VA139652OtherBLUE CROSS OF VA
VAC09165Medicare ID - Type Unspecified
VA239315OtherSOUTHERN HEALTH