Healthcare Provider Details

I. General information

NPI: 1992567762
Provider Name (Legal Business Name): MULTIDISCIPLINARY PAIN CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2024
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3206 TOWER OAKS BLVD STE 200
ROCKVILLE MD
20852-4253
US

IV. Provider business mailing address

3206 TOWER OAKS BLVD STE 200
ROCKVILLE MD
20852-4253
US

V. Phone/Fax

Practice location:
  • Phone: 240-240-9141
  • Fax: 240-240-9141
Mailing address:
  • Phone: 502-386-2444
  • Fax: 240-240-9141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code281PC2000X
TaxonomyChildren's Chronic Disease Hospital
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. M-IRFAN SULEMAN
Title or Position: PEDIATRIC & ADULT PAIN PHYSICIAN
Credential: MD
Phone: 502-386-2444