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General NPI Number Information
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NPI Number | 1336964063
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF MARYLAND ST. JOSEPH PAIN SPECIALISTS, LLC
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 1 TEXAS STATION CT STE 300
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City | TIMONIUM
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State | MD
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Zip | 21093-8289
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Country | US
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Telephone | 410-683-2120
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Fax |
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Provider Business Mailing Address
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Address Line | 900 ELKRIDGE LANDING RD FL 2
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City | LINTHICUM
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State | MD
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Zip | 21090-2924
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | THOMAS B. SMYTH
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Credential |
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Telephone | 410-337-4489
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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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