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Organization

PAIN AND SPINE SPECIALISTS OF MARYLAND, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RITU BHATNAGAR (CREDENTIALING MANAGER)
(224) 365-8401
Entity
Organization

Contact information

Practice address
2702 BACK ACRE CIR STE 290B, MOUNT AIRY, MD 21771-7769
(301) 703-8767
(301) 703-8886
Mailing address
2702 BACK ACRE CIR STE 290B, MOUNT AIRY, MD 21771-7769
(301) 703-8767
(301) 703-8886

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
208VP0000X
Pain Medicine Physician
208VP0014X
Interventional Pain Medicine Physician

Other

Enumeration date
02/27/2020
Last updated
02/27/2020
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