=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922443704
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GLOBAL PAIN MANAGEMENT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/07/2013
-----------------------------------------------------
Last Update Date | 10/24/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8031 RITCHIE HIGHWAY SUITE 100
-----------------------------------------------------
City | PASADENA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21044-1067
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-825-4050
-----------------------------------------------------
Fax | 443-825-4051
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8031 RITCHIE HIGHWAY SUITE 100
-----------------------------------------------------
City | PASADENA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21044-1067
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-825-4050
-----------------------------------------------------
Fax | 443-825-4051
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | HADDIJATOU OGUNSOLA
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 443-825-4050
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207LP2900X
-----------------------------------------------------
Taxonomy Name | Pain Medicine (Anesthesiology) Physician
-----------------------------------------------------
License Number | D0065596
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------