NPI 1902348659 · live from the CMS NPI Registry
1st Medical Pain Management Specialists
Clinic/Center in Edgewater, MD. National Provider Identifier 1902348659, active.
NPI record
| NPI | 1902348659 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center 261Q00000X |
| Practice location | 20 Mayo Rd Ste 201, Edgewater, MD 21037 |
| Practice phone | 410-956-6800 |
| Mailing address | 20 Mayo Rd, Suite 201, Edgewater, MD 21037 |
| Enumerated | November 11, 2016 |
| Last updated | January 23, 2022 |
| Authorized official | Rosemary Ingado, Clinical Administrator |
| Other names | 1st Medical Painrehab Center |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinic/Center, Pain | 261QP3300X | — |
| Clinic/Center, Rehabilitation | 261QR0400X | — |
| Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | 261QR0401X | — |
| Clinic/Center, Rehabilitation, Substance Use Disorder | 261QR0405X | — |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | — |
| Social Worker, Clinical | 1041C0700X | — |
| Contractor | 171W00000X | D40904 (MD) |
| Specialist | 174400000X | — |
| Clinic/Center, Adult Mental Health | 261QM0850X | — |
| Clinic/Center primary | 261Q00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.