Healthcare Provider Details

I. General information

NPI: 1871928812
Provider Name (Legal Business Name): MARYLAND ANESTHESIA & PAIN MANAGEMENT SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2013
Last Update Date: 04/11/2022
Certification Date: 04/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UPPER CHESAPEAKE DR
BEL AIR MD
21014-4324
US

IV. Provider business mailing address

7111 FAIRWAY DR SUITE 450
PALM BEACH GARDENS FL
33418-4204
US

V. Phone/Fax

Practice location:
  • Phone: 443-643-1000
  • Fax:
Mailing address:
  • Phone: 561-623-2052
  • Fax: 865-291-3612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN HOLTZCLAW
Title or Position: OWNER
Credential: M.D.
Phone: 561-623-2000