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General NPI Number Information
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NPI Number | 1225257561
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Entity Type | Organization
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Legal Business Name | PADEN-LIFE-CARE LLC
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2300 OXFORD SHIRE CT
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City | WALDORF
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State | MD
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Zip | 20603-3215
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Country | US
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Telephone | 301-843-1279
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Fax | 301-638-5512
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Provider Business Mailing Address
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Address Line | 2300 OXFORD SHIRE CT
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City | WALDORF
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State | MD
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Zip | 20603-3215
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Country | US
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Telephone | 301-843-1279
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Fax | 301-638-5512
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Authorized Official
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Title or Position | MEMBER MANAGER
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Name | DR. VABIAN LEWITT PADEN
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Credential | MD
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Telephone | 240-682-5440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | D0060744
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License Number State | MD
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