MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE PC NPI 1255607628

NPI Information

  • NPI: 1255607628
  • Provider Name: MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE, PC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Doing Business As: ALLSPINE SURGERY CENTER
  • CLIA Number: 11D2041463
  • Address: 33 UPPER RIVERDALE RD SW
    #25
    RIVERDALE, GA
    ZIP 30274
  • Phone: (770) 997-0600

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NPI Details

MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE, PC is an ambulatory surgical clinic center in Riverdale, GA. MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE, PC NPI is 1255607628. The provider is registered as an organization entity type.
The provider Is Doing Business As Allspine Surgery Center.

The provider's business location address is:

33 UPPER RIVERDALE RD SW
#25
RIVERDALE, GA
ZIP 30274-626
Phone: (770) 997-0600
Fax: (770) 991-5576

The provider's authorized official is Shahram Rezaiamiri .
The authorized official title is Physician and has the following contact phone number (770) 997-0600.

The CLIA number assigned to this NPI record is 11D2041463 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/29/2012 and was last updated on 3/29/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory SurgicalGEORGIAYes

What is NPI?

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This page was last updated on: 11/21/2025

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