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General NPI Number Information
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NPI Number | 1104592898
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Entity Type | Organization
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Legal Business Name | LIGHTHOUSE SPINE CENTER P.C.
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Dates
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Enumeration Date | 08/21/2021
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Last Update Date | 09/23/2022
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Provider Practice Location Address
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Address Line | 7307 MACARTHUR BLVD # 200
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City | BETHESDA
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State | MD
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Zip | 20816-1014
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Country | US
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Telephone | 301-830-8040
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Fax | 833-707-1950
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Provider Business Mailing Address
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Address Line | 6106 HARVARD AVE UNIT 365
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City | GLEN ECHO
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State | MD
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Zip | 20812-7508
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Country | US
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Telephone | 301-830-8040
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ARAM SHAHINYAN
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Credential | MD
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Telephone | 301-830-8040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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