BLUE WATER PAIN SPECIALISTS PC (NPI# 1568889442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568889442 |
| Entity Type | Organization |
| Organization Name | BLUE WATER PAIN SPECIALISTS PC |
| Practice Address |
22101 Moross Rd Detroit MI 48236-2148 |
| Mailing Address |
538 Chase Ln Bloomfield Hills MI 48304-2363 |
| Practice Telephone | 3133434000 |
| Mailing Telephone | 2487927029 |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2017-11-15 |
| Authorized Official Name | BASSAM E. DURGHAM (TREASURER) |
| Authorized Official Telephone | 2487927029 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
22101 MOROSS RD |
| City | DETROIT |
| State | MI |
| Zip Code | 48236-2148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083609887 | Anne M Schneider | Obstetrics & Gynecology | 22101 Moross Rd, 313, Detroit, MI 48236-2148 | 2005-09-19 |
| 1346848827 | Tanya L Locke | Nurse Practitioner | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-10-15 |
| 1588261556 | Ryan Guthrie | Student in an Organized Health Care Education/Training Program | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-10-02 |
| 1578160743 | Lauren Kudirka | Speech-Language Pathologist | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-10-01 |
| 1952918740 | Lisa Colombo | Nurse Practitioner | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-09-26 |
| 1124635917 | Gjergj George Juncaj | Nurse Practitioner | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-09-26 |
| 1194337881 | Lori Holaly | Nurse Practitioner | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-08-23 |
| 1548870066 | Tamara Siblini | Student in an Organized Health Care Education/Training Program | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-08-10 |
| 1104436583 | David Mark Thomas | Student in an Organized Health Care Education/Training Program | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-07-31 |
| 1780293969 | Alexander Swend Mortensen | Student in an Organized Health Care Education/Training Program | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-07-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323966 | Khairya Fatouh | Pathology | 22101 Morros Road, Pathology Department, Detroit, Detroit, MI 48236 | 2020-07-16 |
| 1134744998 | Harish Harry Gidda | Internal Medicine | 22201 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-06-08 |
| 1770107443 | Arshan Ali Khan | Internal Medicine | 22101 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-05-29 |
| 1750901658 | Annika Van Wieren | Emergency Medicine | 22101 Moross Road, Emergency Department, Detroit, MI 48236 | 2020-04-21 |
| 1801449483 | Ishaq Azeem Asghar | Student in an Organized Health Care Education/Training Program | 22101 Moross Road, Pathology Department, Detroit, MI 48236 | 2019-07-22 |
| 1295290443 | Ascension St. John Hospital | Dietitian, Registered | 22201 Moross, Ste. 270, Detriot, MI 48236 | 2019-02-01 |
| 1548747413 | Abiodun Adenuga Adefarasin | Pharmacist | 20746 Mack Avenue, Gross Pointe Woods, MI 48236 | 2018-07-24 |
| 1629564042 | Hamza H Khan | Student in an Organized Health Care Education/Training Program | 22201 Moross, Professional Building 2, Suite 70, Detroit, MI 48236 | 2018-07-09 |
| 1235631664 | David Lee Williams | Physical Therapist | 159 Kercheval Avenue, Grosse Pointe Farms, MI 48236 | 2018-03-01 |
| 1164979720 | Memphie Morgan | Licensed Practical Nurse | 91527 Cheshire St., Grosse Pointe, MI 48236 | 2016-09-01 |
| Find all providers in zip 48236 | ||||
| Taxonomy Code | 208VP0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Pain Medicine |
| Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient’s pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies. |
| Notes: Source: American Academy of Pain Medicine, www.painmed.org - Additional Resources:The American Board of Pain Medicine provides Board Certification. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225301260 | Infinity Pain Management Group Pllc | Pain Medicine | 16921 W Warren Ave Ste B, Detroit, MI 48228-3504 | 2012-02-22 |
| 1679647184 | Vidyachandra R. Vakhariya | Pain Medicine | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2006-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992274450 | Spine & Back Recovery Inc | Pain Medicine | 1975 E Maple Rd, Troy, MI 48083-4214 | 2018-11-14 |
| 1184126906 | Performance Orthopedics of Michigan Pllc | Pain Medicine | 27207 Lahser Rd Ste 108, Southfield, MI 48034-8470 | 2018-03-07 |
| 1689184020 | Midwest Surgical Affiliates, Pllc | Pain Medicine | 8560 N Silvery Ln Ste 202, Dearborn Heights, MI 48127-4515 | 2017-10-11 |
| 1407385529 | Provider Services Network LLC | Pain Medicine | 31500 W 13 Mile Rd Ste 106, Farmington Hills, MI 48334-2172 | 2017-06-12 |
| 1124441258 | Better Care Company,pc | Pain Medicine | 31000 Telegraph Rd Ste 140, Bingham Farms, MI 48025-4361 | 2014-01-24 |
| 1063855823 | Advance Care Visiting Physicians | Pain Medicine | 3550 Burbank Dr, Ann Arbor, MI 48105-1596 | 2013-04-11 |
| 1639438062 | Advanced Diagnostic Medical Imaging PC | Pain Medicine | 19891 Parke Ln, Grosse Ile, MI 48138-1027 | 2012-05-04 |
| 1598081317 | Michigan Institute of Pain Management West | Pain Medicine | 11650 Belleville Road, Van Buren Township, MI 48111 | 2010-04-19 |
| 1447583398 | Dial A Doc Physicians PC | Pain Medicine | 28 N Saginaw, Chase Building, Pontiac, MI 48340 | 2009-09-10 |
| 1033377452 | Arduth Maureen Burgess | Pain Medicine | 1910 W Howell Rd, Mason, MI 48854-9335 | 2008-06-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.