OrganizationActive
Maryland Pain and Spine Center, L.L.C.
NPI 1265683460 · Pain Medicine Physician · Fulton, MD
Provider details
- NPI number
- 1265683460
- Entity type
- Organization
- Primary specialty
- Pain Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Vajira Gunawardane, Director(703) 994-6655
- License
- D0047120 (MD)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
7625 Maple Lawn Blvd
Suite 100
Fulton, MD 20759-2561
Phone: (703) 994-6655
Fax: (410) 730-2812
Approximate (ZIP-level) locationGet directions
Mailing address
7625 Maple Lawn Blvd
Fulton, MD 20759-2561
Registry dates
- Enumerated
- 2008-10-06
- Last updated
- 2009-01-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.