1346218195 NPI number — CARA D NOVICK MD

Table of content: CARA D NOVICK MD (NPI 1346218195)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346218195 NPI number — CARA D NOVICK MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NOVICK
Provider First Name:
CARA
Provider Middle Name:
D
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346218195
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/11/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 741593
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30374-1593
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-668-8544
Provider Business Mailing Address Fax Number:
757-668-6544

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
171 KEMPSVILLE RD
Provider Second Line Business Practice Location Address:
BUILDING A
Provider Business Practice Location Address City Name:
NORFOLK
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23502-4700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-668-6550
Provider Business Practice Location Address Fax Number:
757-668-6544
Provider Enumeration Date:
03/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  ME80677 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207X00000X , with the licence number: 0101249783 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1346218195 . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1346218195 . This is a "VA PREMIER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1346218195 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7540791 . This is a "CIGNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 311610834 . This is a "MDIPA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 311610834 . This is a "UHC" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1346218195 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1346218195 . This is a "MULTIPLAN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1346218195 . This is a "MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 311610834 . This is a "BEECH STREET" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 311610834 . This is a "MAMSI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 311610834 . This is a "VHN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 10082054 . This is a "OPTIMA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 311610834 . This is a "TRICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 5918978 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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