Provider Demographics
NPI:1437458809
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:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:LOEV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-881-7246
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:410-329-1071
Mailing Address - Fax:410-329-1059
Practice Address - Street 1:3460 OLD WASHINGTON RD
Practice Address - Street 2:SUITE 300
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3240
Practice Address - Country:US
Practice Address - Phone:301-645-1523
Practice Address - Fax:301-645-6812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6308020011Medicare NSC