Provider Demographics
NPI:1558169664
Name:ADVANCED PAIN AND NEUROLOGY CENTER
Entity type:Organization
Organization Name:ADVANCED PAIN AND NEUROLOGY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHENGYUN
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:240-220-6600
Mailing Address - Street 1:501 N FREDERICK AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2507
Mailing Address - Country:US
Mailing Address - Phone:240-220-6600
Mailing Address - Fax:
Practice Address - Street 1:501 N FREDERICK AVE STE 302
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2507
Practice Address - Country:US
Practice Address - Phone:240-220-6600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Single Specialty