Provider Demographics
NPI:1720275720
Name:MARYLAND PAIN AND SPINE CENTER, INC
Entity type:Organization
Organization Name:MARYLAND PAIN AND SPINE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAJID
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-326-5397
Mailing Address - Street 1:7321 HANOVER PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3616
Mailing Address - Country:US
Mailing Address - Phone:301-326-5397
Mailing Address - Fax:301-446-2489
Practice Address - Street 1:7321 HANOVER PKWY STE B
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3616
Practice Address - Country:US
Practice Address - Phone:301-326-5397
Practice Address - Fax:301-446-2489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0064244261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain