Maryland Pain Clinic LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

D0074228 Issued in MD

Legal business name

MARYLAND PAIN CLINIC LLC

Practice address

15825 Shady Grove Rd Ste 130
Rockville, MD 20850-4031

Phone

(240) 660-2786

NPI assigned

Feb 22, 2018

Organization subpart

No

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

Authorized official

Name

Mike Yuan, MD

Title

Physician

Phone

(240) 660-2786

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1396246799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15005 SHADY GROVE RD STE 100",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506341",
            "telephone_number": "240-660-2786",
            "fax_number": "301-576-3698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15825 SHADY GROVE RD STE 130",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504031",
            "telephone_number": "240-660-2786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND PAIN CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-22",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "YUAN",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "240-660-2786",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": "D0074228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Rockville, MD
• Providers in Rockville, MD by specialty
• Physical Medicine & Rehabilitation Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.