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Organization
SUMMIT PAIN MANAGEMENT GROUP,INC
Active
Organization
SUMMIT PAIN MANAGEMENT GROUP,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLAKUNLE TAIWO M.D (PRESIDENT AND C.E.O.)
(301) 996-9354
Entity
Organization
Contact information
Practice address
603 REVOLUTION ST, HAVRE DE GRACE, MD 21078-3319
(410) 942-1015
(410) 942-1016
Mailing address
8056 IANS ALY, LAUREL, MD 20724-6133
(301) 996-9354
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
D0050806
MD
251B00000X
Case Management Agency
D0050806
MD
261Q00000X
Clinic/Center
D0050806
MD
Other
Enumeration date
10/03/2011
Last updated
10/03/2011
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