Organization
CENTER FOR SPORTS AND REGENERATIVE ORTHOPEDICS, LLC
Active
Other names
Pain and Wellness Center of Maryland, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIRIAM RAZAQ M.D. (PHYSICIAN)
(240) 754-7954
Entity
Organization
Contact information
Practice address
601 POST OFFICE RD STE 2A, WALDORF, MD 20602
(240) 754-7954
(240) 754-7958
Mailing address
601 POST OFFICE RD STE 2A, WALDORF, MD 20602-1912
(240) 754-7954
(240) 754-7958
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
H67340
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
589609600
—
MD
Enumeration date
12/23/2013
Last updated
04/08/2022
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