Organization
LEGACY SPINE AND PAIN, LLC
Active
Organization
LEGACY SPINE AND PAIN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EHSAN ABDESHAHIAN MD (OWNER)
(410) 800-4466
Entity
Organization
Contact information
Practice address
10421 MOTOR CITY DR # 342430, BETHESDA, MD 20817-9996
(301) 962-4278
(833) 781-1112
Mailing address
10421 MOTOR CITY DR # 342430, BETHESDA, MD 20817-9996
(301) 962-4278
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
03/26/2018
Last updated
12/14/2020
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