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General NPI Number Information
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NPI Number | 1790357077
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Entity Type | Organization
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Legal Business Name | MARYLAND PAIN MANAGEMENT
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Dates
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Enumeration Date | 07/15/2021
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Last Update Date | 07/15/2021
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Provider Practice Location Address
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Address Line | 16005 COMPRINT CIR
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City | GAITHERSBURG
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State | MD
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Zip | 20877-1318
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Country | US
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Telephone | 240-751-8829
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Fax |
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Provider Business Mailing Address
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Address Line | 3 N 2ND ST FL 3
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City | PHILADELPHIA
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State | PA
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Zip | 19106-2299
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Country | US
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Telephone | 610-716-9680
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | BETH LEVIN
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Credential |
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Telephone | 610-716-9680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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