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General NPI Number Information
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NPI Number | 1073470068
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Entity Type | Organization
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Legal Business Name | NIMEL TMS & SPRAVATO CLINIC INC
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Dates
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Enumeration Date | 01/09/2026
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 216 CRAIN HWY N STE 102
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City | GLEN BURNIE
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State | MD
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Zip | 21061-3086
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Country | US
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Telephone | 301-272-1558
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Fax |
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Provider Business Mailing Address
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Address Line | 10801 GREEN ASH LN
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City | BELTSVILLE
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State | MD
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Zip | 20705-3851
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Country | US
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Telephone | 301-272-1558
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Fax | 301-272-1558
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Authorized Official
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Title or Position | DIRECTOR
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Name | MOSUNMOLA LAKE
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Credential |
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Telephone | 301-272-1558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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