Organization
BRIAN J NOVACK DPM
Active
Other names
Brian J Novack DPM INC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN J NOVACK DPM (PRESIDENT)
(440) 944-6665
Entity
Organization
Contact information
Practice address
29630 EUCLID AVE, WICKLIFFE, OH 44092-1829
(440) 944-6665
(440) 944-6672
Mailing address
29630 EUCLID AVE, WICKLIFFE, OH 44092-1829
(440) 944-6665
(440) 944-6672
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
36001391N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000288591
BCBS
OH
05
—
2146270
—
OH
01
—
275645717008
MEDICAL MUTUAL
OH
Enumeration date
01/24/2007
Last updated
11/01/2007
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