MEDICARE: NOVUS PAIN MANAGEMENT - MARYLAND, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician

General Provider Information

NPI Number	:	1205783545
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVUS PAIN MANAGEMENT - MARYLAND, LLC

Provider Business Mailing Address
First Line	:	157 BALTIMORE ST STE 100
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-2472
Country	:	US
Telephone Number	:	301-722-0484
Fax Number	:	833-903-0130

Provider Business Practice Location Address
First Line	:	2015 E WEST HWY
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-2602
Country	:	US
Telephone Number	:	301-722-0484
Fax Number	:	833-903-0130

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	HEATHER ROBOSSON
Credential	:
Telephone Number	:	240-727-3995

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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