Maryland Pain and Spine Center, L.l.c.

NPI #1265683460 in Fulton, Maryland

Provider Information

NPI Number: 1265683460
Entity Type: Organization
Organization Name: Maryland Pain and Spine Center, L.l.c.
Primary Specialty: Pain Medicine - Pain Medicine
Enumeration Date: Oct 6, 2008
Last Updated: Jan 7, 2009

Practice Location

Address: 7625 MAPLE LAWN BLVD
Address 2: SUITE 100
City: Fulton
State: Maryland
ZIP Code: 20759-2561
Phone: (703) 994-6655

Authorized Official

Name: DR. VAJIRA RATHNIN GUNAWARDANE, M.D.
Title: DIRECTOR
Phone: (703) 994-6655

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pain Medicine - Pain Medicine — Pain Medicine	208VP0000X	Primary

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