Healthcare Provider Details

I. General information

NPI: 1265317614
Provider Name (Legal Business Name): NEWBRIDGE SPINE AND PAIN CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3581 OLD WASHINGTON RD STE F
WALDORF MD
20602-3270
US

IV. Provider business mailing address

3581 OLD WASHINGTON RD STE F
WALDORF MD
20602-3270
US

V. Phone/Fax

Practice location:
  • Phone: 301-638-4400
  • Fax: 301-638-2200
Mailing address:
  • Phone: 301-638-4400
  • Fax: 301-638-2200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DEBRA TURNER
Title or Position: COO
Credential:
Phone: 240-651-3986