Organization
MATSUNAGA PAIN MANAGEMENT LLC
Active
Other names
Innovative Health Labs
Organization subpart
No
Provider details
NPI number
Authorized official
TIM KARTISEK (BILLING SUPERVISOR)
(443) 371-7749
Entity
Organization
Contact information
Practice address
9755 PATUXENT WOODS DR, SUITE 100, COLUMBIA, MD 21046-2286
(410) 218-3458
Mailing address
8894 STANFORD BLVD, SUITE 104, COLUMBIA, MD 21045-4794
(410) 997-7246
(410) 997-7226
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
21D2117103
MD
Other
Enumeration date
08/26/2016
Last updated
08/26/2016
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