OrganizationActive
Interventional Pain Management Services LLC
NPI 1710018247 · Interventional Pain Medicine Physician · Florissant, MO
Provider details
- NPI number
- 1710018247
- Entity type
- Organization
- Primary specialty
- Interventional Pain Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mahendra Gunapooti, President(314) 830-2600
- License
- 036112334 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
261 Dunn Rd
Florissant, MO 63031-7928
Phone: (314) 830-2600
Fax: (314) 830-2648
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 650
Edwardsville, IL 62025-0650
Additional practice locations (1)
- 2421 Corporate Ctr Ste 105Granite City, IL 62040-4195Phone: (314) 830-2600Fax: (314) 830-2648
Registry dates
- Enumerated
- 2007-03-08
- Last updated
- 2026-05-06
- Certified
- 2026-05-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.