Provider Demographics
NPI:1356077697
Name:NAVA HEALTH MEDICAL GROUP, LLC
Entity Type:Organization
Organization Name:NAVA HEALTH MEDICAL GROUP, LLC
Other - Org Name:NAVA HEALTH AND VITALITY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MUIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-910-5959
Mailing Address - Street 1:9755 PATUXENT WOODS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2288
Mailing Address - Country:US
Mailing Address - Phone:800-762-6282
Mailing Address - Fax:
Practice Address - Street 1:43670 GREEWAY CORPORATE DRIVE
Practice Address - Street 2:SUITE 122
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-2104
Practice Address - Country:US
Practice Address - Phone:800-762-6282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAVA HEALTH MEDICAL GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-28
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty