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General NPI Number Information
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NPI Number | 1407669971
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Entity Type | Organization
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Legal Business Name | PAIN AND SPINE SPECIALISTS OF MARYLAND, LLC
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 6816 DEERPATH RD
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City | ELKRIDGE
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State | MD
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Zip | 21075-7392
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Country | US
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Telephone | 301-760-3310
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Fax | 301-703-8766
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Provider Business Mailing Address
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Address Line | 2702 BACK ACRE CIR STE 290B
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City | MOUNT AIRY
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State | MD
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Zip | 21771-7769
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Country | US
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Telephone | 301-760-3317
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Fax | 301-703-8766
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Authorized Official
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Title or Position | OWNER
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Name | SUDHIR R RAO
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Credential |
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Telephone | 301-703-8767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #3
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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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