Healthcare Provider Details

I. General information

NPI: 1245400415
Provider Name (Legal Business Name): PAIN MANAGEMENT AND ANESTHESIA SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 03/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 DIDONATO DR
CHESTER MD
21619-2628
US

IV. Provider business mailing address

PO BOX 155
CHESTER MD
21619-0155
US

V. Phone/Fax

Practice location:
  • Phone: 410-725-8672
  • Fax: 301-218-1061
Mailing address:
  • Phone: 410-725-8672
  • Fax: 301-218-1061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberD0037421
License Number StateMD

VIII. Authorized Official

Name: DR. FELIX D. BARNETT
Title or Position: PRESIDENT
Credential: M.D.
Phone: 410-725-8672