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
1	363L00000X	Nurse Practitioner
2	363A00000X	Physician Assistant
3	208100000X	Physical Medicine & Rehabilitation Physician
4	208VP0000X	Pain Medicine Physician
5	208VP0014X	Interventional Pain Medicine Physician
6	225400000X	Rehabilitation Practitioner
7	174400000X	Specialist
8	207L00000X	Anesthesiology Physician
9	207LP2900X	Pain Medicine (Anesthesiology) Physician
10	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1922374255
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	:	410-571-2946
Fax Number	:	410-573-4862

Provider Business Practice Location Address
First Line	:	3261 OLD WASHINGTON RD STE 3010
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	:
Telephone Number	:	410-571-2946

Provider Enumeration Date	:	03/30/2012
Last Update Date	:	04/13/2023

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