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General NPI Number Information
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NPI Number | 1639669716
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Entity Type | Organization
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Legal Business Name | ADVANCED PAIN MANAGEMENT,LLC
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Dates
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Enumeration Date | 05/15/2018
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Last Update Date | 08/21/2018
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Provider Practice Location Address
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Address Line | 1050 KEY PKWY STE 104
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City | FREDERICK
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State | MD
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Zip | 21702
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Country | US
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Telephone | 240-629-3920
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Fax | 240-629-3921
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Provider Business Mailing Address
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Address Line | 1050 KEY PKWY STE 104
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City | FREDERICK
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State | MD
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Zip | 21702-4496
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Country | US
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Telephone | 240-629-3920
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Fax | 240-629-3921
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Authorized Official
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Title or Position | CEO
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Name | KHALID KAHLOON
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Credential |
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Telephone | 240-629-3990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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