OrganizationActive
Interventional Pain Specialists of Michigan PLLC
NPI 1124402607 · Interventional Pain Medicine Physician · Southgate, MI
Provider details
- NPI number
- 1124402607
- Entity type
- Organization
- Primary specialty
- Interventional Pain Medicine PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Siva Sripada, Admin
- License
- 5101016685 (MI)
Practice location
13460 Fort St
Southgate, MI 48195-1138
Phone: (313) 263-5961
Fax: (313) 263-5963
Mailing address
14000 Dix Toledo Rd
Southgate, MI 48195-9500
Registry dates
- Enumerated
- 2015-07-15
- Last updated
- 2015-07-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.