Individual
NOVERA INAM INAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
795 SIM HODGIN PKWY, REID HEALTH RESIDENCY CLINIC, RICHMOND, IN 47374-1928
(765) 966-5949
(765) 962-6268
Mailing address
126 PARKS HALL, ATHENS, OH 45701-1359
(740) 593-4609
(740) 593-4166
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01061456A
IN
207Q00000X
Family Medicine Physician
35.123422
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001099709
ANTHEM
IN
05
—
200821660
—
IN
01
—
259730174
MEDICARE
IN
Enumeration date
06/02/2006
Last updated
05/14/2021
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