Healthcare Provider Details

I. General information

NPI: 1225617897
Provider Name (Legal Business Name): NAVA HEALTH MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2021
Last Update Date: 12/08/2023
Certification Date: 12/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9755 PATUXENT WOODS DR STE 100
COLUMBIA MD
21046-2288
US

IV. Provider business mailing address

9755 PATUXENT WOODS DR STE 100
COLUMBIA MD
21046-2288
US

V. Phone/Fax

Practice location:
  • Phone: 800-762-6282
  • Fax: 410-630-5781
Mailing address:
  • Phone: 800-762-6282
  • Fax: 410-630-5781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: TAMMY MUIR
Title or Position: COMPLIANCE OFFICER
Credential:
Phone: 410-910-5959