Organization
POTOMAC SPINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAL KAHLOON (CEO)
(240) 629-3990
Entity
Organization
Contact information
Practice address
1050 KEY PKWY STE 103, FREDERICK, MD 21702-4496
(240) 629-3982
Mailing address
1050 KEY PKWY, SUITE 202, FREDERICK, MD 21702-4053
(240) 629-3990
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
12/13/2016
Last updated
03/17/2018
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