Provider Demographics
NPI:1003383720
Name:CENTER FOR PAIN MANAGEMENT LLC
Entity Type:Organization
Organization Name:CENTER FOR PAIN MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANISH
Authorized Official - Middle Name:SHARAD
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-620-0012
Mailing Address - Street 1:11350 MCCORMICK ROAD
Mailing Address - Street 2:EP1, SUITE 501
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031-1002
Mailing Address - Country:US
Mailing Address - Phone:410-329-1071
Mailing Address - Fax:410-329-1054
Practice Address - Street 1:6820 HOSPITAL DR STE 302
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4362
Practice Address - Country:US
Practice Address - Phone:410-682-2823
Practice Address - Fax:410-682-9551
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTER FOR PAIN MANAGEMENT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site