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General NPI Number Information
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NPI Number | 1679529481
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Entity Type | Organization
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Legal Business Name | ADVANCED PAIN AND SPINE CENTER
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11119 ROCKVILLE PIKE, SUITE 105
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City | ROCKVILLE
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State | MD
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Zip | 20852
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Country | US
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Telephone | 240-691-4377
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Fax |
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Provider Business Mailing Address
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Address Line | 518-7 OLD POST ROAD, SUITE 115
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City | EDISON
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State | NJ
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Zip | 08817
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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 | OWNER
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Name | DR. ATIF MALIK
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Credential | M.D.
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Telephone | 240-691-4377
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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 | 25MA08033200
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License Number State | NJ
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Taxonomy #2
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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 | D0060663
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License Number State | MD
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