MEDICARE: PAIN MANAGEMENT CENTER

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
1	174400000X	Specialist

General Provider Information

NPI Number	:	1568586501
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAIN MANAGEMENT CENTER

Provider Business Mailing Address
First Line	:	8521 THORNDEN TER
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20817-6809
Country	:	US
Telephone Number	:	301-469-6619
Fax Number	:	301-469-6732

Provider Business Practice Location Address
First Line	:	6475 NEW HAMPSHIRE AVE
Second Line	:	SUITE 430
City	:	HYATTSVILLE
State	:	MD
Zip	:	20783-3269
Country	:	US
Telephone Number	:	301-559-8400
Fax Number	:	301-559-9572

Authorized Official
Title or Position	:	FOUNDER
Name	:	DR. MARTIN ROOSEVELT MCLAREN
Credential	:
Telephone Number	:	301-559-8400

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	07/09/2008

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Directions to “PAIN MANAGEMENT CENTER ” Practice Location

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