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General NPI Number Information
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NPI Number | 1306672654
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Entity Type | Organization
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Legal Business Name | GREATER MARYLAND PAIN MANAGEMENT, LLC
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Dates
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Enumeration Date | 09/12/2024
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 7845 OAKWOOD RD STE 201
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City | GLEN BURNIE
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State | MD
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Zip | 21061-4257
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Country | US
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Telephone | 410-672-2255
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Fax | 410-816-9472
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Provider Business Mailing Address
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Address Line | 1130 ANNAPOLIS RD STE 100
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City | ODENTON
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State | MD
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Zip | 21113-1622
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Country | US
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Telephone | 410-672-2255
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Fax | 410-816-9472
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Authorized Official
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Title or Position | CEO
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Name | JANAK A VIDYARTHI
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Credential |
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Telephone | 410-672-2255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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