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Individual

MICHAEL A NOVAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3401 ENTERPRISE PKWY, SUITE 300, BEACHWOOD, OH 44122-7344
(216) 831-5700
(216) 839-4905
Mailing address
24075 COMMERCE PARK, BEACHWOOD, OH 44122-5846
(216) 831-5700
(216) 839-4905

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
048833
OH
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
35-048833
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000027302
ANTHEM
OH
01
0004057921
AETNA
OH
05
0826931
OH
01
180030562
RAILROAD MEDICARE
OH
Enumeration date
06/20/2005
Last updated
06/28/2021
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