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NPI Code Detail

MEDICARE: ADVANCED PAIN MANAGEMENT SPECIALISTS, LLC

MEDICARE: ADVANCED PAIN MANAGEMENT SPECIALISTS, 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
1208100000XPhysical Medicine & Rehabilitation Physician
22081P2900XPain Medicine (Physical Medicine & Rehabilitation) Physician
3208VP0000XPain Medicine Physician
4207L00000XAnesthesiology Physician
5207LP2900XPain Medicine (Anesthesiology) Physician
6225100000XPhysical Therapist
7291U00000XClinical Medical Laboratory
8332B00000XDurable Medical Equipment & Medical Supplies
9363A00000XPhysician Assistant
10363L00000XNurse Practitioner
11208VP0014XInterventional Pain Medicine Physician

General Provider Information

NPI Number : 1407379753
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED PAIN MANAGEMENT SPECIALISTS, LLC
Provider Business Mailing Address
First Line : 201 DEFENSE HWY STE 205
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21401-7096
Country : US
Telephone Number : 855-527-7246
Fax Number : 866-229-5063
Provider Business Practice Location Address
First Line : 3261 OLD WASHINGTON RD STE 3010A
Second Line :
City : WALDORF
State : MD
Zip : 20602-3229
Country : US
Telephone Number : 855-527-7246
Fax Number : 866-229-5063
Authorized Official
Title or Position : CEO
Name : DAMEAN FREAS
Credential : DO
Telephone Number : 410-571-2946
Provider Enumeration Date : 07/19/2017
Last Update Date : 08/29/2024

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