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MARYLAND BRAIN SPINE & PAIN LLC NPI 1396713913


NPI Information

NPI: 1396713913
Provider Name: MARYLAND BRAIN SPINE & PAIN LLC
Classification: Neurological Surgery - 207T00000X
Entity Type: Organization

CLIA Number: 21D2083382

Address:
1000 BESTGATE RD STE 400
ANNAPOLIS, MD
ZIP 21401
Phone: (410) 266-2720
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MARYLAND BRAIN SPINE & PAIN LLC is a neurological surgery in Annapolis, MD. The provider is a neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. MARYLAND BRAIN SPINE & PAIN LLC NPI is 1396713913. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1000 BESTGATE RD STE 400
ANNAPOLIS, MD
ZIP 21401-371
Phone: (410) 266-2720
Fax: (410) 224-0209

The provider's authorized official is Brian J Sullivan .
The authorized official title is President/physician and has the following contact phone number (410) 266-2720.

The CLIA number assigned to this NPI record is 21D2083382 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/9/2006 and was last updated on 4/26/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207T00000XNeurological SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1404557200MEDICAIDMARYLAND
2J457OTHERBCBS
3530AMAOTHERBCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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