Provider Demographics
NPI:1871135053
Name:GLOBAL PAIN MANAGEMENT LLC
Entity type:Organization
Organization Name:GLOBAL PAIN MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HADDITATOU
Authorized Official - Middle Name:SECKA
Authorized Official - Last Name:OGUNSOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-825-4050
Mailing Address - Street 1:130 LOVE POINT RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21666-1400
Mailing Address - Country:US
Mailing Address - Phone:443-825-4050
Mailing Address - Fax:443-825-4051
Practice Address - Street 1:130 LOVE POINT RD
Practice Address - Street 2:SUITE 106
Practice Address - City:STEVENSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21666-1400
Practice Address - Country:US
Practice Address - Phone:443-825-4050
Practice Address - Fax:443-825-4051
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GLOBAL PAIN MANAGEMENT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty