Organization
CHARLES C NOVAK MD CHARTERED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALISON DUNBAR (BILLING SUPERVISOR)
(208) 323-1125
Entity
Organization
Contact information
Practice address
413 N ALLUMBAUGH ST STE 101, BOISE, ID 83704-9219
(208) 323-1125
Mailing address
413 N ALLUMBAUGH ST STE 101, BOISE, ID 83704-9219
(208) 323-1125
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
M4922
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770511743
INDIVIDUAL NPI
—
Enumeration date
03/04/2011
Last updated
03/04/2011
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