Individual
MR. SCOTT D NOVASCONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN,RRT
Contact information
Practice address
407 BROTHERTON ST, WAKEFIELD, MI 49968-1326
(906) 224-1337
Mailing address
407 BROTHERTON ST, WAKEFIELD, MI 49968-1326
(906) 224-1337
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704263822
MI
174400000X
Specialist
2338-28
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2338-28
STATE OF WISCONSIN
MI
01
—
4704263822
STATE OF MICHIGAN
MI
Enumeration date
02/05/2009
Last updated
02/05/2009
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