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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
1207LP2900XPain Medicine (Anesthesiology) Physician
2208100000XPhysical Medicine & Rehabilitation Physician
3208VP0000XPain Medicine Physician
4208VP0014XInterventional Pain Medicine Physician
5332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1598217291
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED PAIN MANAGEMENT SPECIALISTS, LLC
Provider Business Mailing Address
First Line : 201 DEFENSE HWY
Second Line : SUITE 205
City : ANNAPOLIS
State : MD
Zip : 21401-8943
Country : US
Telephone Number : 410-571-2946
Fax Number : 410-571-2947
Provider Business Practice Location Address
First Line : 10905 FORT WASHINGTON RD STE 405
Second Line :
City : FT WASHINGTON
State : MD
Zip : 20744-5807
Country : US
Telephone Number : 410-571-2946
Fax Number :
Authorized Official
Title or Position : CEO/D.O.
Name : DAMEAN FREAS
Credential : D.O.
Telephone Number : 410-571-2946
Provider Enumeration Date : 10/28/2016
Last Update Date : 04/13/2023

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