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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
62081P2900XPain Medicine (Physical Medicine & Rehabilitation) Physician

General Provider Information

NPI Number : 1760979116
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 : 443-837-9914
Fax Number :
Provider Business Practice Location Address
First Line : 331 OAK MANOR DR STE 102
Second Line :
City : GLEN BURNIE
State : MD
Zip : 21061-5553
Country : US
Telephone Number : 410-571-2946
Fax Number :
Authorized Official
Title or Position : VP OPERATIONS
Name : BRITNI CULLEN
Credential :
Telephone Number : 443-837-9913
Provider Enumeration Date : 04/20/2018
Last Update Date : 09/10/2018

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