Provider Demographics
NPI:1063132140
Name:SEVOX MEDICAL SERVICES
Entity type:Organization
Organization Name:SEVOX MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:OSAGEDE
Authorized Official - Last Name:IMOMOH
Authorized Official - Suffix:
Authorized Official - Credentials:DNAP
Authorized Official - Phone:240-898-5075
Mailing Address - Street 1:13219 EXECUTIVE PARK TER
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-2647
Mailing Address - Country:US
Mailing Address - Phone:443-548-0484
Mailing Address - Fax:240-744-5661
Practice Address - Street 1:13219 EXECUTIVE PARK TER
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-2647
Practice Address - Country:US
Practice Address - Phone:443-548-0484
Practice Address - Fax:240-744-5661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty