Organization
1ST MEDICAL PAIN MANAGEMENT SPECIALISTS
Active
Parent organization
1ST MEDICAL OF ANNAPOLIS INC
Other names
1st Medical Painrehab Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
1ST MEDICAL OF ANNAPOLIS INC
Authorized official
ROSEMARY INGADO PA (CLINICAL ADMINISTRATOR)
(410) 956-6800
Entity
Organization
Contact information
Practice address
20 MAYO RD STE 201, EDGEWATER, MD 21037-1442
(410) 956-6800
(410) 956-6803
Mailing address
20 MAYO RD, SUITE 201, EDGEWATER, MD 21037-1439
(410) 956-6800
(410) 956-6803
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
171W00000X
Contractor
D40904
MD
174400000X
Specialist
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QP3300X
Pain Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
923020300
—
MD
Enumeration date
11/11/2016
Last updated
01/23/2022
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