Organization
ADVANCED PAIN MANAGEMENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHALID A KAHLOON (CEO)
(502) 261-7200
Entity
Organization
Contact information
Practice address
1050 KEY PKWY STE 103, FREDERICK, MD 21702-4496
(240) 629-3939
(240) 629-3940
Mailing address
1050 KEY PKWY STE 202, FREDERICK, MD 21702-4551
(240) 629-3939
(240) 629-3940
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
162840
MEDICARE PTAN (LOCALITY 99)
MD
01
—
181909
MEDICARE PTAN
DC
01
—
276470
MEDICARE PTAN (LOCALITY 01)
MD
Enumeration date
12/31/2008
Last updated
03/17/2018
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