Advanced Pain Management Pllc

NPI #1114171519 in Meridian, Idaho

Provider Information

NPI Number
1114171519
Entity Type
Organization
Organization Name
Advanced Pain Management Pllc
Primary Specialty
Anesthesiology - Pain Medicine
Enumeration Date
Nov 11, 2008
Last Updated
Nov 23, 2011

Practice Location

Address
2275 SO EAGLE RD
Address 2
SUTE 160
State
Idaho
ZIP Code
83642
Phone
(208) 947-2266

Authorized Official

Name
MICHAEL DALE SEVERSON, MD
Title
MEMBER
Phone
(208) 880-9464

Specialties & Taxonomy Codes

Specialty
Anesthesiology - Pain MedicinePain Medicine

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