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Organization
MARYLAND PAIN AND SPINE CENTER, L.L.C.
Active
Organization
MARYLAND PAIN AND SPINE CENTER, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VAJIRA RATHNIN GUNAWARDANE M.D. (DIRECTOR)
(703) 994-6655
Entity
Organization
Contact information
Practice address
7625 MAPLE LAWN BLVD, SUITE 100, FULTON, MD 20759-2561
(703) 994-6655
(410) 730-2812
Mailing address
7625 MAPLE LAWN BLVD, SUITE 100, FULTON, MD 20759-2561
(703) 994-6655
(410) 730-2812
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
D0047120
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272541000
—
MD
Enumeration date
10/06/2008
Last updated
01/07/2009
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