Provider Demographics
NPI:1578078804
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:MARK
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:LOEV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-881-7246
Mailing Address - Street 1:11350 MCCORMICK ROAD
Mailing Address - Street 2:EXECUTIVE PLAZA 1, 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 1:5801 ALLENTOWN ROAD
Practice Address - Street 2:503
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746
Practice Address - Country:US
Practice Address - Phone:301-877-6110
Practice Address - Fax:301-877-2695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-08
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty