Organization
SPINE MEDICINE AND REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRA D KORNBLUTH M.D. (OWNER)
(202) 607-9788
Entity
Organization
Contact information
Practice address
7920 MCDONOGH RD, 201, OWINGS MILLS, MD 21117-5273
(443) 321-2590
Mailing address
826 WASHINGTON RD, SUITE 210, WESTMINSTER, MD 21157-5750
(202) 607-9788
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
D0061293
MD
Other
Enumeration date
11/11/2007
Last updated
05/16/2013
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