Individual
MR. CHARLES WHEELER NOVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP-PMH
Contact information
Practice address
12145 ELM ST, PRINCESS ANNE, MD 21853-1358
(410) 651-2204
(410) 651-0790
Mailing address
PO BOX 1978, SALISBURY, MD 21802-1978
(410) 749-1015
(410) 749-0654
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
0024168080
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R119086
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119591300
—
MD
Enumeration date
01/03/2008
Last updated
03/14/2016
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