Provider Demographics
NPI:1417998394
Name:ADVANCED PAIN SOLUTIONS, PC
Entity Type:Organization
Organization Name:ADVANCED PAIN SOLUTIONS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GREASER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-548-4300
Mailing Address - Street 1:1320 CENTRAL PARK BLVD
Mailing Address - Street 2:SUITE 405
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-4942
Mailing Address - Country:US
Mailing Address - Phone:540-548-4300
Mailing Address - Fax:540-548-2777
Practice Address - Street 1:1320 CENTRAL PARK BLVD
Practice Address - Street 2:SUITE 405
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4942
Practice Address - Country:US
Practice Address - Phone:540-548-4300
Practice Address - Fax:540-548-2777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058826208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09576Medicare ID - Type Unspecified