Organization
MASSUMI REHABILITATION & PAIN MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEHRDAD MICHAEL MASSUMI M.D. (PRESIDENT/OWNER)
(410) 825-5905
Entity
Organization
Contact information
Practice address
660 KENILWORTH DR, SUITE 200, TOWSON, MD 21204-2313
(410) 825-5905
(410) 825-7712
Mailing address
660 KENILWORTH DR, SUITE 200, TOWSON, MD 21204-2313
(410) 825-5905
(410) 825-7712
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
D0032831
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091911000
—
MD
01
—
426194
COVENTRY
—
Enumeration date
05/19/2014
Last updated
05/19/2014
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