Provider Demographics
NPI:1578282471
Name:METROPOLITAN PAIN PA
Entity Type:Organization
Organization Name:METROPOLITAN PAIN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEVI
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-367-0011
Mailing Address - Street 1:9501 OLD ANNAPOLIS RD STE 305
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-6337
Mailing Address - Country:US
Mailing Address - Phone:301-490-6698
Mailing Address - Fax:
Practice Address - Street 1:9501 OLD ANNAPOLIS RD STE 305
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-6337
Practice Address - Country:US
Practice Address - Phone:301-490-6698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METROPOLITAN PAIN PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical