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General NPI Number Information
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NPI Number | 1063132140
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Entity Type | Organization
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Legal Business Name | SEVOX MEDICAL SERVICES
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Dates
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Enumeration Date | 08/30/2022
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Last Update Date | 06/24/2026
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Provider Practice Location Address
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Address Line | 13219 EXECUTIVE PARK TER
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City | GERMANTOWN
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State | MD
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Zip | 20874-2647
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Country | US
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Telephone | 443-548-0484
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Fax | 240-744-5661
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Provider Business Mailing Address
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Address Line | 13219 EXECUTIVE PARK TER
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City | GERMANTOWN
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State | MD
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Zip | 20874-2647
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Country | US
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Telephone | 240-762-4141
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Fax | 240-744-5661
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Authorized Official
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Title or Position | CRNA
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Name | DR. MICHAEL OSAGEDE IMOMOH
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Credential | DNAP
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Telephone | 240-898-5075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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