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General NPI Number Information
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NPI Number | 1316315740
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Entity Type | Organization
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Legal Business Name | ADVANCED PAIN MANAGEMENT SPECIALISTS, LLC
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Dates
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Enumeration Date | 09/02/2015
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 7920 MCDONOGH RD STE 205
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5273
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Country | US
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Telephone | 410-571-2946
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Fax |
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Provider Business Mailing Address
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Address Line | 201 DEFENSE HWY SUITE 205
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City | ANNAPOLIS
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State | MD
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Zip | 21401-8943
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Country | US
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Telephone | 443-837-9914
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. DAMEAN FREAS
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Credential | DO
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Telephone | 410-571-2946
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 140870
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License Number State | MD
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