Individual
DR. MATTHEW JAMES NOVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20 GLENLAKE PKWY, KAISER PERMANENTE GLENLAKE MEDICAL OFFICE, ATLANTA, GA 30328-3473
(770) 677-6227
Mailing address
3495 PIEDMONT RD NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1717
(404) 364-7000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
048552
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020048465
RAILROAD MEDICARE
GA
05
—
0899258A
—
GA
Enumeration date
02/07/2007
Last updated
01/13/2022
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