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NPI Code Detail

MEDICARE: GREATER MARYLAND PAIN MANAGEMENT, LLC

MEDICARE: GREATER MARYLAND PAIN MANAGEMENT, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208VP0014XInterventional Pain Medicine Physician

General Provider Information

NPI Number : 1003744897
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREATER MARYLAND PAIN MANAGEMENT, LLC
Provider Business Mailing Address
First Line : 1130 ANNAPOLIS RD STE 100
Second Line :
City : ODENTON
State : MD
Zip : 21113-1622
Country : US
Telephone Number : 410-672-2255
Fax Number :
Provider Business Practice Location Address
First Line : 2800 SOLLERS POINT RD
Second Line :
City : DUNDALK
State : MD
Zip : 21222-4647
Country : US
Telephone Number : 410-672-2255
Fax Number :
Authorized Official
Title or Position : CEO
Name : JANAK A VIDYARTHI
Credential : MD
Telephone Number : 410-672-2255
Provider Enumeration Date : 05/12/2026
Last Update Date : 05/12/2026

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Directions to “GREATER MARYLAND PAIN MANAGEMENT, LLC ” Practice Location

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