Provider Demographics
NPI:1962836403
Name:KAMRAN SARAF MD PA
Entity Type:Organization
Organization Name:KAMRAN SARAF MD PA
Other - Org Name:POTOMAC SPINE & PAIN SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAMRAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SARAF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-650-9080
Mailing Address - Street 1:10953 DEBORAH DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2718
Mailing Address - Country:US
Mailing Address - Phone:240-650-9080
Mailing Address - Fax:240-650-9081
Practice Address - Street 1:17904 GEORGIA AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-2239
Practice Address - Country:US
Practice Address - Phone:240-650-9080
Practice Address - Fax:240-650-9081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-01
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0072402207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty