Healthcare Provider Details

I. General information

NPI: 1124939681
Provider Name (Legal Business Name): NOVOHEALTH PRIMARY CARE CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 OSLER DR STE 113
TOWSON MD
21204-7705
US

IV. Provider business mailing address

7600 OSLER DR STE 113
TOWSON MD
21204-7705
US

V. Phone/Fax

Practice location:
  • Phone: 443-852-3291
  • Fax:
Mailing address:
  • Phone: 443-852-3291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SADAF MUSTAFA
Title or Position: MEDICAL DIRECTOR/OWNER
Credential: MD, DABOM
Phone: 443-852-3291