Individual
KERRY W. NOVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 MEDICAL PKWY, CARSON CITY, NV 89703-4625
(775) 445-8005
Mailing address
1600 MEDICAL PKWY, CARSON CITY, NV 89703-4625
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
9276
NV
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
9276
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201317507
—
NV
01
—
B014
TRICARE
NV
01
—
NV4644
BCBS
NV
Enumeration date
11/01/2006
Last updated
04/15/2010
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