| Maryland Pain & Regenerative Center, Llc | |
|
6128 Brandon Ave Ste 208210 Springfield VA 22150-2640 | |
| (301) 659-0003 | |
| (301) 829-7694 |
| Full Name | Maryland Pain & Regenerative Center, Llc |
|---|---|
| Speciality | Pain Medicine |
| Location | 6128 Brandon Ave Ste 208210, Springfield, Virginia |
| Authorized Official Name and Position | Ritu Varma (OWNER/PHYSICIAN) |
| Authorized Official Contact | 4198197394 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maryland Pain & Regenerative Center, Llc 12070 Old Line Ctr Waldorf MD 20602-2513 Ph: (419) 819-7394 | Maryland Pain & Regenerative Center, Llc 6128 Brandon Ave Ste 208210 Springfield VA 22150-2640 Ph: (301) 659-0003 |
| NPI Number | 1104467463 |
|---|---|
| Provider Enumeration Date | 10/07/2019 |
| Last Update Date | 08/21/2024 |
| Medicare PECOS PAC ID | 1951736438 |
|---|---|
| Medicare Enrollment ID | O20200109001885 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104467463 | NPI | - | NPPES |
| Provider Name | Ritu Varma |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1215112537 PECOS PAC ID: 4880850353 Enrollment ID: I20120727000363 |
| Provider Name | Suzanne A Yaras |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609885672 PECOS PAC ID: 1658370150 Enrollment ID: I20190403001464 |
| Provider Name | Robert Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487071981 PECOS PAC ID: 7315205622 Enrollment ID: I20190502000067 |
| Provider Name | Riara Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497521454 PECOS PAC ID: 8123479391 Enrollment ID: I20250304002060 |
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