Provider Demographics
NPI:1619228459
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:PHYSICAN/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:
Authorized Official - Phone:301-881-7246
Mailing Address - Street 1:11921 ROCKVILLE PIKE
Mailing Address - Street 2:SUITE 505
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2737
Mailing Address - Country:US
Mailing Address - Phone:301-881-7246
Mailing Address - Fax:
Practice Address - Street 1:11921 ROCKVILLE PIKE
Practice Address - Street 2:SUITE 505
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2737
Practice Address - Country:US
Practice Address - Phone:301-881-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD658LMedicare PIN
DCG00027Medicare PIN