Healthcare Provider Details

I. General information

NPI: 1386549657
Provider Name (Legal Business Name): NOVUS PAIN MANAGEMENT - DELAWARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 BALTIMORE STREET, SUITE 302
CUMBERLAND MD
21502-2472
US

IV. Provider business mailing address

157 BALTIMORE ST STE 302
CUMBERLAND MD
21502-2472
US

V. Phone/Fax

Practice location:
  • Phone: 301-722-0484
  • Fax: 833-903-0130
Mailing address:
  • Phone: 301-722-0484
  • Fax: 833-903-0130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: HEATHER ROBOSSON
Title or Position: PRACTICE MANAGER
Credential:
Phone: 240-727-3995