NPIMap

Organization Active NPI

Carroll County Mso Inc

  • Pain Medicine (Anesthesiology) Physician
  • Mount Airy, MD
National Provider Identifier
1992856025
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
D0047120 Issued in MD
Legal business name
CARROLL COUNTY MSO INC
Practice address
208 E Ridgeville Blvd
201
Mount Airy, MD 21771-5219
Phone
(301) 829-7683
Fax
(301) 829-7694
NPI assigned
Jan 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Authorized official

Name
Vajira Gunawardane, MD
Title
Physician Director
Phone
(410) 871-6139

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X D0047120 MD Primary

Addresses

Primary practice location

208 E Ridgeville Blvd
201
Mount Airy, MD 21771-5219

Mailing address

291 Stoner Ave
Westminster, MD 21157-5647
Phone (410) 871-6139

National Provider Directory

National Provider Directory

Locations

4500 Black Rock Rd
Hampstead, MD 21074
Phone (410) 239-0406

1502 S Main St
Ste 205
Mount Airy, MD 21771
Phone (301) 829-5860

1502 S Main St
Mount Airy, MD 21771
Phone (301) 663-6171

444 Wmc Dr
Ste 114
Westminster, MD 21158
Phone (410) 751-6684

41 Magna Way
Ste 100
Westminster, MD 21157
Phone (410) 751-6684

1130 Baltimore Blvd
Ste C
Westminster, MD 21157
Phone (410) 876-7772

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1992856025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 STONER AVE",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575647",
            "telephone_number": "410-871-6139",
            "fax_number": "410-871-6112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 E RIDGEVILLE BLVD",
            "address_2": "201",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217715219",
            "telephone_number": "301-829-7683",
            "fax_number": "301-829-7694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLL COUNTY MSO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "GUNAWARDANE",
        "authorized_official_first_name": "VAJIRA",
        "authorized_official_title_or_position": "PHYSICIAN DIRECTOR",
        "authorized_official_telephone_number": "410-871-6139",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MD",
            "license": "D0047120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.