Organization
REVIVAL PAIN MANAGEMENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMIDIO MICHAEL NOVEMBRE DO (PRACTICE OWNER)
(336) 835-5330
Entity
Organization
Contact information
Practice address
1925 N BRIDGE ST STE 101, ELKIN, NC 28621-2105
(336) 835-5330
(336) 835-5337
Mailing address
1925 N BRIDGE ST STE 101, ELKIN, NC 28621-2105
(336) 835-5330
(336) 835-5337
Taxonomy
Speciality
Code
Description
License number
State
207LA0401X
Addiction Medicine (Anesthesiology) Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
07/16/2006
Last updated
11/20/2025
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