Organization
PROVIDENCE PAIN MANAGEMENT CENTER, PA
Active
Parent organization
PROVIDENCE PAIN MANAGEMENT CENTER, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE PAIN MANAGEMENT CENTER, PA
Authorized official
AKARA FORSYTHE MD (CEO)
(301) 750-9500
Entity
Organization
Contact information
Practice address
14201 LAUREL PARK DR, SUITE 223, LAUREL, MD 20707
(301) 798-9300
(301) 355-2101
Mailing address
6911 LAUREL BOWIE RD, SUITE 212, BOWIE, MD 20721
(301) 750-9500
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
03/07/2019
Last updated
10/22/2019
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