Provider Demographics
NPI:1619263456
Name:ALLIED PAIN MANAGEMENT CONSULTANTS INC
Entity Type:Organization
Organization Name:ALLIED PAIN MANAGEMENT CONSULTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AUBREY
Authorized Official - Middle Name:
Authorized Official - Last Name:VERDUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-770-6301
Mailing Address - Street 1:121 CONGRESSIONAL LN
Mailing Address - Street 2:#204
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1542
Mailing Address - Country:US
Mailing Address - Phone:301-770-6301
Mailing Address - Fax:734-586-7328
Practice Address - Street 1:4938 HAMPDEN LN
Practice Address - Street 2:#206
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2914
Practice Address - Country:US
Practice Address - Phone:301-770-6301
Practice Address - Fax:734-586-7328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-20
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0066729208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD552126200Medicaid