NPIMap

Advantia Health Spine-Sports & Pain Center of Maryland LLC

Organization Active NPI Pain Medicine (Anesthesiology) Physician · Beltsville, MD

NPI 1629447453 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1629447453
Entity type
Organization (NPI type 2)
Primary specialty
Pain Medicine (Anesthesiology) Physician 207LP2900X
Legal business name
ADVANTIA HEALTH SPINE-SPORTS & PAIN CENTER OF MARYLAND LLC
Practice address
12240 Indian Creek CT
Suite 130a
Beltsville, MD 20705-1242
Phone
(571) 327-1334
Fax
(240) 264-8436
NPI assigned
Sep 22, 2015
Organization subpart
Yes
Parent organization (as reported)
ADVANTIA HOLDINGS OF MARYLAND LLC

Authorized official

Name
Dr. Peter Glass, MD
Title
Cmo
Phone
(301) 453-5970

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

National Provider Directory

Part of
Advantia Holdings of Maryland LLC

Locations

12240 Indian Creek Ct
Ste 130A
Beltsville, MD 20705
Phone (301) 453-5970

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207LP2900X Yes

Addresses

Primary practice location

12240 Indian Creek CT
Suite 130a
Beltsville, MD 20705-1242

Mailing address

1400 Forest Glen Rd Ste 500
Silver Spring, MD 20910-1467
Phone (301) 453-5970

Other providers in Beltsville, MD

All providers in Beltsville, MD · Pain Medicine (Anesthesiology) Physician in Maryland

Sources for this page

Verify at the official NPI Registry.