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NPI Code Detail

MEDICARE: NOVUS PAIN MANAGEMENT - MARYLAND, LLC

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
12081P2900XPain Medicine (Physical Medicine & Rehabilitation) Physician

General Provider Information

NPI Number : 1316792369
Entity Type Code : Organization
Provider Name (Legal Business Name) : NOVUS PAIN MANAGEMENT - MARYLAND, LLC
Provider Business Mailing Address
First Line : 157 BALTIMORE ST
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 : 2501 MUSGROVE RD
Second Line :
City : SILVER SPRING
State : MD
Zip : 20904-7128
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 : 04/23/2024
Last Update Date : 06/18/2024

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