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General NPI Number Information
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NPI Number | 1942713540
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Entity Type | Organization
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Legal Business Name | ADVANCED PAIN MEDICINE INSTITUTE
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Dates
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Enumeration Date | 11/06/2017
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Last Update Date | 11/06/2017
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Provider Practice Location Address
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Address Line | 8500 ANNAPOLIS RD SUITE 200
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City | NEW CARROLLTON
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State | MD
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Zip | 20784-1331
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Country | US
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Telephone | 301-220-1333
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Fax | 301-220-1533
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Provider Business Mailing Address
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Address Line | 8500 ANNAPOLIS RD SUITE 200
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City | NEW CARROLLTON
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State | MD
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Zip | 20784-1331
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Country | US
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Telephone | 301-220-1333
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Fax | 301-220-1533
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Authorized Official
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Title or Position | CEO
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Name | REZA GHORBANI
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Credential | M.D.
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Telephone | 301-220-1333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | BH000064
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License Number State | MD
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