Individual
MARION R NOVAK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
501 ROBERTSON BLVD, WALTERBORO, SC 29488-2787
(843) 497-5929
(843) 497-9940
Mailing address
4615 OLEANDER DR, MYRTLE BEACH, SC 29577-5741
(843) 497-5929
(843) 497-9940
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1000
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0311PA
—
SC
Enumeration date
07/18/2005
Last updated
07/08/2007
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