Provider Demographics
NPI:1619556735
Name:METROSPINE PC
Entity Type:Organization
Organization Name:METROSPINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAKES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-856-5860
Mailing Address - Street 1:6188 OXON HILL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-1373
Mailing Address - Country:US
Mailing Address - Phone:301-856-5860
Mailing Address - Fax:301-856-5864
Practice Address - Street 1:9001 WOODYARD RD
Practice Address - Street 2:SUITE A
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-1400
Practice Address - Country:US
Practice Address - Phone:301-856-5860
Practice Address - Fax:301-856-5864
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METROSPINE PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty