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Individual

DR. NORMAN NOVELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
US HWY 491 NORTH, SHIPROCK, NM 87420
(505) 368-6001
(505) 368-7011
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6001
(505) 368-7011

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
040500
GA
207YP0228X
Pediatric Otolaryngology Physician
040500
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00669721E
GA
Enumeration date
11/09/2005
Last updated
03/07/2023
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