Individual
MARK NOVOTNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 LOCUST STREET, NORTHAMPTON, MA 01061
(413) 582-2792
(413) 582-4675
Mailing address
PO BOX 911, 30 LOCUST STREET, NORTHAMPTON, MA 01061-0911
(413) 582-2898
(413) 582-2958
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
042-0006447
VT
207R00000X
Internal Medicine Physician
Primary
46176
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005274
—
VT
01
—
046176
CONNECTICARE
MA
05
—
110087091A
—
MA
01
—
110738
BMC HEALTH NET
MA
01
—
1427072479
FALLON COMMUNITY HEALTH PLAN
MA
01
—
44189
HEALTH NEW ENGLAND
MA
01
—
4540683
AETNA
MA
01
—
6004659
CIGNA
MA
01
—
754694
TUFTS
MA
01
—
AA191022
HARVARD PILGRIM HEALTH PLAN
MA
Enumeration date
07/26/2006
Last updated
12/30/2010
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