Provider Demographics
NPI:1043610900
Name:CENTER FOR PAIN MANAGEMENT, LLC
Entity Type:Organization
Organization Name:CENTER FOR PAIN MANAGEMENT, LLC
Other - Org Name:NATIONAL SPINE AND PAIN CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANISH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-620-0012
Mailing Address - Street 1:PO BOX 74166
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44194-4166
Mailing Address - Country:US
Mailing Address - Phone:410-265-7300
Mailing Address - Fax:410-265-9533
Practice Address - Street 1:940 SETON DR
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1818
Practice Address - Country:US
Practice Address - Phone:301-777-2543
Practice Address - Fax:301-777-2583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-28
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6308020018Medicare NSC