Individual
DR. DONALD E NOVICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5779 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Mailing address
5779 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
21486
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
336215
—
AZ
01
—
86080015085259A343
TRIWEST
AZ
Enumeration date
12/08/2005
Last updated
10/30/2007
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