Provider Demographics
NPI:1386399921
Name:EVON MEDICS TMS GROUP
Entity type:Organization
Organization Name:EVON MEDICS TMS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:NWAOKOBIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-888-7678
Mailing Address - Street 1:11053 HUNTERS VIEW RD
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-6100
Mailing Address - Country:US
Mailing Address - Phone:914-888-7678
Mailing Address - Fax:
Practice Address - Street 1:6021 UNIVERSITY BLVD STE 250-260
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-6077
Practice Address - Country:US
Practice Address - Phone:914-888-7678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty