Summit Pain Management Group,Inc

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

D0050806 Issued in MD

Legal business name

SUMMIT PAIN MANAGEMENT GROUP,INC

Practice address

603 Revolution St
Havre de Grace, MD 21078-3319

Phone

(410) 942-1015

Fax

(410) 942-1016

NPI assigned

Oct 3, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Olakunle Taiwo, M.D

Title

President and C.E.O.

Phone

(301) 996-9354

Specialties & licenses 3

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317600000000",
    "number": "1124302690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8056 IANS ALY",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207246133",
            "telephone_number": "301-996-9354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 REVOLUTION ST",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783319",
            "telephone_number": "410-942-1015",
            "fax_number": "410-942-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT PAIN MANAGEMENT GROUP,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-03",
        "last_updated": "2011-10-03",
        "status": "A",
        "authorized_official_last_name": "TAIWO",
        "authorized_official_first_name": "OLAKUNLE",
        "authorized_official_title_or_position": "PRESIDENT AND C.E.O.",
        "authorized_official_telephone_number": "301-996-9354",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MD",
            "license": "D0050806",
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "MD",
            "license": "D0050806",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MD",
            "license": "D0050806",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017816740003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Stephen, LCSW-C
• Lauren Knott Stephens, OD
• Steven C. Marks, MD, PA
• Summit Ambulatory Surgical Center LLC
• Summit Chiropractic P.a.
• Susquehanna Counseling Services LLC
• Susquehanna Health and Wellness
• Susquehanna OB-GYN LLC
• Madison Brooke Tamberino, DPT
• The Care Group at Safe Harbor

• Pain Medicine (Anesthesiology) Physician in Havre de Grace, MD
• Providers in Havre de Grace, MD by specialty
• Pain Medicine (Anesthesiology) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.