Organization
MID ATLANTIC PAIN MANAGEMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN P WOODS MD (CHIEF MEDICAL OFFICER)
(214) 687-0015
Entity
Organization
Contact information
Practice address
6355 WALKER LN, SUITE 200, ALEXANDRIA, VA 22310-3245
(301) 829-7683
(301) 829-7694
Mailing address
PO BOX 610624, DALLAS, TX 75261-0624
(800) 394-4445
(706) 650-1034
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0352193
AETNA HMO
—
01
—
618183700
USDOL OWCP - FEDERAL BLACK LUNG
—
01
—
BE66
CAREFIRST BC/BS
—
01
—
DV0457
RAILROAD MEDICARE
—
Enumeration date
03/10/2014
Last updated
03/07/2019
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