MARYLAND INTERVENTIONAL PAIN MANAGEMENT, LLC (NPI# 1568749125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568749125 |
| Entity Type | Organization |
| Organization Name | MARYLAND INTERVENTIONAL PAIN MANAGEMENT, LLC |
| Other Organization Name | BALTIMORE PAIN RELIEF CENTER |
| Practice Address |
5430 Campbell Blvd Suite 106 White Marsh MD 21162-5500 |
| Practice Telephone | 4437254930 |
| Practice Fax Number | 4437254933 |
| Mailing Telephone | 4437254930 |
| Mailing Fax Number | 4437254933 |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2012-04-30 |
| Authorized Official Name | MR. TIMOTHY J GOBER (OWNER) |
| Authorized Official Telephone | 4437254930 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 3470 | MD | Chiropractic Providers |
| N | 207R00000X | Internal Medicine | 73023 | MD | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 20215 | MD | Allopathic & Osteopathic Physicians |
| N | 363A00000X | Physician Assistant | 3824 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 3868 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 208D00000X | General Practice | 60828 | MD | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Baltimore Pain Relief Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053670430 | Maryland Interventional Pain Management, LLC | Chiropractor | 1147 S Hanover St, Baltimore, MD 21230-3717 | 2012-05-07 |
| Street Address |
5430 CAMPBELL BLVD SUITE 106 |
| City | WHITE MARSH |
| State | MD |
| Zip Code | 21162-5500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568423606 | Sudhir Sekhsaria | Allergy & Immunology | 5430 Campbell Blvd, Suite 103, White Marsh, MD 21162-5500 | 2006-03-29 |
| 1548758493 | Annette M. Schlossnagle | Social Worker | 5430 Campbell Blvd, White Marsh, MD 21162-5500 | 2018-04-26 |
| 1427508878 | Choice Pain and Rehabilitation Center | Physical Medicine & Rehabilitation | 5430 Campbell Blvd, Suite 110b, White Marsh, MD 21162-5500 | 2016-10-10 |
| 1376990200 | White Marsh Healthcare Physical Medicine,llc | Clinical Medical Laboratory | 5430 Campbell Blvd, Suite 106, White Marsh, MD 21162-5500 | 2016-05-20 |
| 1942674163 | White Marsh Healthcare & Physical Medicine,llc | Clinical Medical Laboratory | 5430 Campbell Blvd, Ste 106, White Marsh, MD 21162-5500 | 2015-11-27 |
| 1972971968 | Michelle Okafor | Audiologist | 5430 Campbell Blvd, Suite 212, White Marsh, MD 21162-5500 | 2015-09-08 |
| 1417364340 | Mohamad Alabrash, M.d. | Internal Medicine | 5430 Campbell Blvd, White Marsh, MD 21162-5500 | 2014-07-11 |
| 1083987317 | Amber Giesel Viel | Nurse Practitioner | 5430 Campbell Blvd, Suite 103, White Marsh, MD 21162-5500 | 2012-02-16 |
| 1508135328 | Julien Mignon | Chiropractor | 5430 Campbell Blvd, Suite 106, White Marsh, MD 21162-5500 | 2011-12-22 |
| 1356619803 | Maryland Interventional Pain Management LLC | Internal Medicine | 5430 Campbell Blvd, Suite 106, White Marsh, MD 21162-5500 | 2011-12-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285250191 | Michael Nwandu Dnp, Pmhnp-bc, LLC | Clinic/Center | 5702 Country Farm Road, White Marsh, MD 21162 | 2020-06-17 |
| 1104168590 | Justin Ryan Brooks | General Practice | 11500 Lipscomb Way, White Marsh, MD 21162 | 2013-03-23 |
| 1841410974 | Glenn Paul Miller | Dentist | 11550 Philadelphia Road Suite #118, Whitemarsh, MD 21162 | 2007-04-30 |
| 1063722700 | White Marsh Healthcare Physical Medicine LLC | Chiropractor | 5430 Campbell Blvd., Ste. 106, White Marsh, MD 21162 | 2010-10-15 |
| 1275164139 | Maria Lourdes Evangelista | Nurse Practitioner | 5728 Fieldcrest Dr, White Marsh, MD 21162-1143 | 2020-01-30 |
| 1730669771 | Marilyn C Hernandez | Nurse Practitioner | 5700 Fieldcrest Dr, White Marsh, MD 21162-1143 | 2018-08-20 |
| 1639635584 | Rebecca Dawn Rock | Social Worker | 5717 Fieldcrest Dr, White Marsh, MD 21162-1144 | 2019-02-15 |
| 1508245564 | Watermark Health Services LLC | Home Health | 11511 Ridgedale Dr, White Marsh, MD 21162-1146 | 2015-05-23 |
| 1275845521 | Martha Angela Montemar | Physical Therapist | 5606 Crescent Ridge Dr, White Marsh, MD 21162-1149 | 2010-07-01 |
| 1952925836 | Allstar Care Agency, LLC | Home Health | 11586 Autumn Terrace Dr, White Marsh, MD 21162-1151 | 2020-06-05 |
| Find all providers in zip 21162 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104168590 | Justin Ryan Brooks | General Practice | 11500 Lipscomb Way, White Marsh, MD 21162 | 2013-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700490950 | Arlene Elizabeth George | General Practice | 1500 W Perimeter Rd Ste 4350, Jb Andrews, MD 20762-6604 | 2020-09-04 |
| 1891303038 | Lorenzo Leggio | General Practice | Nih/nida, Bayview Campus, Brc, 251 Bayview Boulevard, Room 01a844, Baltimore, MD 21224 | 2020-07-14 |
| 1548889447 | Canary Doctor LLC | General Practice | 8904 Maxwell Dr, Potomac, MD 20854-3124 | 2020-04-10 |
| 1083247894 | Medstar Medical Group II LLC | General Practice | 9101 Franklin Square Drive, Ste 200, Medical Arts Building, Baltimore, MD 21237-4072 | 2020-02-20 |
| 1881239838 | Avicention LLC | General Practice | 350c Fortune Ter # 227, Potomac, MD 20854-2980 | 2019-11-14 |
| 1972148963 | My Primary Care | General Practice | 826 Washington Rd Ste 110, Westminster, MD 21157-5779 | 2019-11-13 |
| 1619512837 | David Newsome | General Practice | 12305 Sandalwood Lane, Silver Spring, MD 20904 | 2019-11-12 |
| 1720623242 | Assured Access Medical Associates Inc. | General Practice | 7221 Hanover Pkwy Ste C, Greenbelt, MD 20770-2022 | 2019-11-07 |
| 1780240671 | Capstone Treatment Center, Inc | General Practice | 1133 E West Hwy Apt 204e, Silver Spring, MD 20910-4804 | 2019-05-15 |
| 1861058935 | Revive Treatment Center Inc | General Practice | 1133 E West Hwy Apt 1515w, Silver Spring, MD 20910-6833 | 2019-05-14 |
| Find all providers with the same taxonomy | ||||
| City | WHITE MARSH |
| Zip Code | 21162 |
Please comment or provide details below to improve the information on MARYLAND INTERVENTIONAL PAIN MANAGEMENT, LLC.
| 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.