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General NPI Number Information
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NPI Number | 1558076018
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Entity Type | Organization
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Legal Business Name | ALTERNATIVE DEPRESSION AND PAIN LLC
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Dates
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Enumeration Date | 01/19/2023
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Last Update Date | 01/19/2023
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Provider Practice Location Address
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Address Line | 10401 OLD GEORGETOWN RD STE 305
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City | BETHESDA
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State | MD
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Zip | 20814-1911
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Country | US
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Telephone | 855-646-8963
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Fax | 855-646-8963
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Provider Business Mailing Address
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Address Line | 1920 SUNRISE DR
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City | POTOMAC
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State | MD
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Zip | 20854-2680
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Country | US
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Telephone | 202-236-0574
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. MATTHEW MINTZ
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Credential | MD
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Telephone | 202-236-0574
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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