Individual
NOAH NOVEMBRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 692-1000
Mailing address
579 TIMBERBROOK TRL, STATE ROAD, NC 28676-8982
(336) 831-3546
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
LL87562
SC
207Q00000X
Family Medicine Physician
LL87562
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
SC
Other
Enumeration date
03/30/2022
Last updated
06/23/2023
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