# PROVIDENCE PAIN MANAGEMENT CENTER, PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROVIDENCE PAIN MANAGEMENT CENTER, PA
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1346708492
- **Legal business name:** PROVIDENCE PAIN MANAGEMENT CENTER, PA
- **Authorized official:** AKARA FORSYTHE MD (CEO)
- **Authorized official phone:** (301) 750-9500

## Contact information

- **Practice address:** 14201 LAUREL PARK DR, SUITE 223, LAUREL, MD 20707
- **Practice address phone:** (301) 798-9300
- **Practice address fax:** (301) 355-2101
- **Mailing address:** 6911 LAUREL BOWIE RD, SUITE 212, BOWIE, MD 20721
- **Mailing address phone:** (301) 750-9500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/07/2019
- **Last updated:** 10/22/2019