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Organization
PAIN AND SPINE SPECIALISTS OF MARYLAND, LLC
Active
Organization
PAIN AND SPINE SPECIALISTS OF MARYLAND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUDHIR R RAO MD (OWNER)
(301) 703-8767
Entity
Organization
Contact information
Practice address
7200 BANK CT STE 120, FREDERICK, MD 21703-2886
(310) 703-8767
Mailing address
2702 BACK ACRE CIR STE 290B, MOUNT AIRY, MD 21771-7769
(301) 703-8767
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
191009228
STATE LICENSE
MD
Enumeration date
01/03/2020
Last updated
01/03/2020
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