| Pain And Spine Specialists Of Maryland, Llc | |
|
2702 Back Arce Circle 290b Mount Airy MD 21771-7769 | |
| (301) 703-8767 | |
| (301) 703-8766 |
| Full Name | Pain And Spine Specialists Of Maryland, Llc |
|---|---|
| Speciality | Specialist |
| Location | 2702 Back Arce Circle, Mount Airy, Maryland |
| Authorized Official Name and Position | Sudhir Rao (OWNER) |
| Authorized Official Contact | 3107038767 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pain And Spine Specialists Of Maryland, Llc 2702 Back Acre Cir Ste 290b Mount Airy MD 21771-7769 Ph: (301) 703-8767 | Pain And Spine Specialists Of Maryland, Llc 2702 Back Arce Circle 290b Mount Airy MD 21771-7769 Ph: (301) 703-8767 |
| NPI Number | 1174884258 |
|---|---|
| Provider Enumeration Date | 06/05/2012 |
| Last Update Date | 06/27/2025 |
| Certification Date | 06/27/2025 |
| Medicare PECOS PAC ID | 2668628124 |
|---|---|
| Medicare Enrollment ID | O20120816000109 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174884258 | NPI | - | NPPES |
| Provider Name | Sudhir R Rao |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1629103759 PECOS PAC ID: 6608965223 Enrollment ID: I20081002000443 |
| Provider Name | Jehangir K Madan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164744397 PECOS PAC ID: 0648395517 Enrollment ID: I20130923000478 |
| Provider Name | Catherine Hays |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194816066 PECOS PAC ID: 1557582947 Enrollment ID: I20150803001032 |
| Provider Name | Suhas Badarinath |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1821133323 PECOS PAC ID: 7214008804 Enrollment ID: I20150814014522 |
| Provider Name | Savitha Rao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780084590 PECOS PAC ID: 0547528390 Enrollment ID: I20201030001043 |
| Provider Name | Samantha Nazaroff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467975698 PECOS PAC ID: 0345507844 Enrollment ID: I20221025001873 |
| Provider Name | Orchid Mesias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710627880 PECOS PAC ID: 1355713306 Enrollment ID: I20230221001011 |
| Provider Name | Praveen Mambalam |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790942886 PECOS PAC ID: 5597822387 Enrollment ID: I20240223002411 |
| Provider Name | Nicholas Kinback |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1497167654 PECOS PAC ID: 0143562686 Enrollment ID: I20240415001462 |
| Provider Name | Christine Shuey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801574603 PECOS PAC ID: 0648627018 Enrollment ID: I20240429001094 |
| Provider Name | Greg Hites |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104233907 PECOS PAC ID: 0042501819 Enrollment ID: I20240502002301 |
| Provider Name | Caleb Daekyu Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649413758 PECOS PAC ID: 5597298406 Enrollment ID: I20241031000258 |
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