Organization · Type 2 NPI

Maryland Pain & Regenerative Center, LLC

Interventional Pain Medicine Physician · Waldorf, MD

NPI number 1104467463 Active

Practice location

3500 Old Washington Rd Ste 202
Waldorf, MD 20602-3238

Mailing address

2296 Opitz Blvd, Ste 110 - 120
Woodbridge, VA 22191-3300

Other practice locations

  • 6128 Brandon Ave Ste 208210, Springfield, VA 22150-2640 · (301) 659-0003
  • 2296 Opitz Blvd Ste 110120, Woodbridge, VA 22191-3300 · (301) 829-7693

Specialties and licenses

TaxonomyCodeLicense
Pain Medicine (Anesthesiology) Physician 207LP2900XNone listed
Family Medicine Physician 207Q00000XNone listed
Internal Medicine Physician 207R00000XNone listed
Geriatric Medicine (Internal Medicine) Physician 207RG0300XNone listed
General Practice Physician 208D00000XNone listed
Pain Medicine Physician 208VP0000XNone listed
Interventional Pain Medicine Physician Primary 208VP0014XNone listed
Physical Therapist 225100000XNone listed
Certified Registered Nurse Anesthetist 367500000XNone listed

Interventional Pain Medicine Physician: Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

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About NPI 1104467463

Maryland Pain & Regenerative Center, LLC's National Provider Identifier is 1104467463, issued on Oct 7, 2019. The primary taxonomy on file is Interventional Pain Medicine Physician (208VP0014X), and the practice location is in Waldorf, MD. The record was last updated on May 1, 2026.