Healthcare Provider Details

I. General information

NPI: 1740638469
Provider Name (Legal Business Name): NOVA INTERVENTIONAL PAIN MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2016
Last Update Date: 03/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9114 PHILADELPHIA RD STE 214
BALTIMORE MD
21237-4348
US

IV. Provider business mailing address

PO BOX 489
CHURCHVILLE MD
21028-0489
US

V. Phone/Fax

Practice location:
  • Phone: 410-676-1463
  • Fax: 844-874-7501
Mailing address:
  • Phone: 410-676-1463
  • Fax: 888-997-6363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number140450
License Number StateMD

VIII. Authorized Official

Name: DR. FAISAL ALEX SAYEED
Title or Position: MANAGING MEMBER
Credential: M.D.
Phone: 410-676-1463