Individual
ROBERT H NOVACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
90 RIVIERA DR, LAKE HAVASU CITY, AZ 86403-5716
(928) 855-7800
(928) 855-5392
Mailing address
90 RIVIERA DR, LAKE HAVASU CITY, AZ 86403-5716
(928) 855-7800
(928) 855-5392
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0180
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
0180
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
700048
—
AZ
01
—
AZ0065230
BCBS AZ
AZ
Enumeration date
01/25/2006
Last updated
04/09/2012
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