Healthcare Provider Details

I. General information

NPI: 1013745710
Provider Name (Legal Business Name): INTEGRAHEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 ADCLARE RD
ROCKVILLE MD
20850-3825
US

IV. Provider business mailing address

9722 GROFFS MILL DR # 916
OWINGS MILLS MD
21117-6341
US

V. Phone/Fax

Practice location:
  • Phone: 301-279-9000
  • Fax:
Mailing address:
  • Phone: 410-870-9380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: KAMAL SALAH H SEWARALTHAHAB
Title or Position: CO OWNER
Credential:
Phone: 410-646-2100