MARYLAND MEDICINAL LLC (NPI# 1255878526) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255878526 |
| Entity Type | Organization |
| Organization Name | MARYLAND MEDICINAL LLC |
| Practice Address |
2002 Medical Pkwy Suite 150 Annapolis MD 21401-3046 |
| Practice Telephone | 4105719000 |
| Practice Fax Number | 4105711670 |
| Mailing Telephone | 4105719000 |
| Mailing Fax Number | 4105711670 |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2017-01-25 |
| Authorized Official Name | BRIAN KAHAN (MEMBER) |
| Authorized Official Telephone | 4105719000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
2002 MEDICAL PKWY SUITE 150 |
| City | ANNAPOLIS |
| State | MD |
| Zip Code | 21401-3046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366448953 | Ayanna L James | Obstetrics & Gynecology | 2002 Medical Pkwy, Suite 635, Annapolis, MD 21401-3046 | 2005-06-28 |
| 1336611466 | Lauren Mason | Social Worker | 2002 Medical Pkwy, Annapolis, MD 21401-3046 | 2018-12-31 |
| 1184131542 | Amanda Nicole Minnitte | Physical Therapy Assistant | 2002 Medical Pkwy, Annapolis, MD 21401-3046 | 2018-01-08 |
| 1669917993 | Back To Fit Inc. | Physical Medicine & Rehabilitation | 2002 Medical Pkwy, 150, Annapolis, MD 21401-3046 | 2016-12-22 |
| 1821549528 | Anne Arundel Physician Group, LLC | Family Medicine | 2002 Medical Pkwy, Suite 460, Annapolis, MD 21401-3046 | 2016-10-18 |
| 1114372497 | Anne Arundel Physician Group, LLC | Clinical Neuropsychologist | 2002 Medical Pkwy, Suite 430, Annapolis, MD 21401-3046 | 2016-04-25 |
| 1487040036 | Gaurav Srivastava | Ophthalmology | 2002 Medical Pkwy, Annapolis, MD 21401-3046 | 2015-04-10 |
| 1164828679 | Med-park LLC | Pharmacy | 2002 Medical Pkwy, Ste 170, Annapolis, MD 21401-3046 | 2014-11-10 |
| 1992147631 | Zachary Scott La Fratta | Audiologist | 2002 Medical Pkwy, Suite 230 Sajak Building, Annapolis, MD 21401-3046 | 2013-07-23 |
| 1134479975 | Krystle Marie Hanna | Audiologist | 2002 Medical Pkwy, Suite 230, Annapolis, MD 21401-3046 | 2012-09-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497377154 | Michael Khorsandi | Student in an Organized Health Care Education/Training Program | 2001 Medical Parkway, Clatanoff Pavillon, Gmw Office, Annapolis, MD 21401 | 2020-05-15 |
| 1275172033 | Katrice N Nelson | Massage Therapist | Wellsview Cottage Center, 613 Ridgely Avenue, Annapolis, MD 21401 | 2019-12-27 |
| 1548803521 | Victoria Reimnitz | Behavioral Analyst | 2028 Indusrtrial Dr, Ste B&c, Annapolis, MD 21401 | 2019-10-23 |
| 1700438140 | Emily Megan Burke | Nurse Practitioner | 200 Forbes St Annapolis, Md 21401, Suite 200, Annapolis, MD 21401 | 2019-07-16 |
| 1316504848 | Sherina Maryam Shamsa | Counselor | 1830 Forest Drive, Suite H-2, Annapolis, MD 21401 | 2019-05-21 |
| 1497225288 | Jerilyn Deitch | Speech-Language Pathologist | Anne Arundel County Public Schools, 2644 Riva Rd, Annapolis, MD 21401 | 2018-12-05 |
| 1487124038 | Lucinda W Mimms | Speech-Language Pathologist | 2644 Riva Rd., Annapolis, MD 21401 | 2018-11-27 |
| 1487145496 | Michelle Baudean | Behavior Technician | 1919 West St Ste 201, Annapolis, MD 21401 | 2018-05-24 |
| 1730678954 | Stephanie Ruth Streb | Registered Nurse | 130 Admiral Cochrane Dr Ste 103, Annapolis, MD 21401 | 2018-05-02 |
| 1780183947 | Annapolis Sleep Center LLC | Clinic/Center | 2451 Riva Rd, Annapolis, MD 21401 | 2018-02-02 |
| Find all providers in zip 21401 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669917993 | Back To Fit Inc. | Physical Medicine & Rehabilitation | 2002 Medical Pkwy, 150, Annapolis, MD 21401-3046 | 2016-12-22 |
| 1215194840 | Brian S Kahan Do Pa | Physical Medicine & Rehabilitation | 170 Jennifer Rd Ste 240, Annapolis, MD 21401-7995 | 2008-05-21 |
| 1831107200 | Brian S Kahan Do Pa | Physical Medicine & Rehabilitation | 2002 Medical Pkwy, Suite 150a, Annapolis, MD 21401-1538 | 2006-08-03 |
| 1366468282 | Richard Genato | Physical Medicine & Rehabilitation | 2002 Medical Parkway, Suite 150, Annapolis, MD 21401-3046 | 2006-07-14 |
| 1740210814 | Brian Scot Kahan | Physical Medicine & Rehabilitation | 170 Jennifer Rd Ste 240, Annapolis, MD 21401-7995 | 2006-07-04 |
| 1659357911 | Thomas Sangwok Lee | Physical Medicine & Rehabilitation | 2002 Medical Pkwy, Suite 430, Annapolis, MD 21401-3046 | 2005-12-19 |
| 1114917937 | William Tham | Physical Medicine & Rehabilitation | 2002 Medical Pkwy, Suite 430, Annapolis, MD 21401-3046 | 2005-10-24 |
| 1558359661 | Physical Medicine & Pain Management Associates, P.C. | Physical Medicine & Rehabilitation | 2002 Medical Pkwy, Suite 430, Annapolis, MD 21401-3046 | 2005-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285123869 | Eastside Medical Care | Physical Medicine & Rehabilitation | 732b E Main St, Salisbury, MD 21804-5037 | 2018-05-09 |
| 1225588676 | Choice Pain & Rebabilitation Center LLC | Physical Medicine & Rehabilitation | 7106 Ridge Rd Ste 100, Rosedale, MD 21237-3876 | 2016-10-10 |
| 1497203558 | Choice Pain & Rebabilitation Center LLC | Physical Medicine & Rehabilitation | 6615 Reisterstown Rd Ste 302, Baltimore, MD 21215-2689 | 2016-09-19 |
| 1558757914 | Choice Pain & Rebabilitation Center LLC | Physical Medicine & Rehabilitation | 3413 Olandwood Ct Ste 103, Olney, MD 20832-1489 | 2015-04-13 |
| 1033505391 | Choice Pain & Rebabilitation Center LLC | Physical Medicine & Rehabilitation | 6475 New Hampshire Ave Ste 620, Hyattsville, MD 20783-3280 | 2015-04-13 |
| 1477948842 | Choice Pain & Rebabilitation Center LLC | Physical Medicine & Rehabilitation | 1005 Northpoint Blvd Ste 722, Baltimore, MD 21224-3402 | 2015-04-02 |
| 1225459936 | Pain and Wellness Center of Maryland, LLC | Physical Medicine & Rehabilitation | 601 Post Office Rd Ste 2a, Waldorf, MD 20602 | 2013-12-23 |
| 1922429935 | Health Management and Rehabilitation LLC | Physical Medicine & Rehabilitation | 13907 Willow Tree Dr, Rockville, MD 20850-5434 | 2013-12-17 |
| 1548681638 | Better Life Pain Clinic, Pllc | Physical Medicine & Rehabilitation | 3459 St. John's Lane, Suite 9, Ellicott City, MD 21042 | 2013-12-17 |
| 1871868539 | Physical Medicine Associates Ltd | Physical Medicine & Rehabilitation | 174 Waterfront St, Suite 320, National Harbor, MD 20745 | 2012-03-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.