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General NPI Number Information
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NPI Number | 1407244890
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Entity Type | Organization
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Legal Business Name | COMFORT INTERVENTIONAL PAIN CENTER, LLC
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Dates
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Enumeration Date | 01/07/2015
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Last Update Date | 01/07/2015
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Provider Practice Location Address
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Address Line | 1406B CRAIN HWY S SUITE 208
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City | GLEN BURNIE
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State | MD
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Zip | 21061-4099
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Country | US
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Telephone | 443-410-3309
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Fax |
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Provider Business Mailing Address
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Address Line | 1406B CRAIN HWY S SUITE 208
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City | GLEN BURNIE
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State | MD
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Zip | 21061-4099
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Country | US
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Telephone | 443-410-3309
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | MR. PIUS AFRIYIE
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Credential | PA-C
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Telephone | 443-410-3309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | C0004208
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License Number State | MD
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