Individual
MICHAEL EDWARD NOVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4070 LAKE DR SE, GRAND RAPIDS, MI 49546-8294
(616) 949-4340
(616) 949-4341
Mailing address
4070 LAKE DR SE, GRAND RAPIDS, MI 49546-8294
(616) 949-4340
(616) 949-4341
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301040101
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699459
—
MI
01
—
340003124
RAILROAD MEDICARE
—
01
—
340D160430
BCBSM
MI
Enumeration date
08/30/2006
Last updated
12/11/2013
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