OrganizationActive
Interventional Pain & Anesthesia Consultants PLLC
NPI 1164877692 · Pain Medicine (Anesthesiology) Physician · Dearborn, MI
Provider details
- NPI number
- 1164877692
- Entity type
- Organization
- Primary specialty
- Pain Medicine (Anesthesiology) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Bryant Ittiara, President(734) 604-0017
- License
- 5101017919 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
20100 Outer Dr
Dearborn, MI 48124-2647
Phone: (734) 604-0017
Approximate (ZIP-level) locationGet directions
Mailing address
416 James Cir
Royal Oak, MI 48067-4545
Registry dates
- Enumerated
- 2016-05-03
- Last updated
- 2017-03-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.