Organization
NOVELLO SPECIALTY CLINIC PC
Active
Organization
NOVELLO SPECIALTY CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN ELLIOTT (DIRECTOR, OPERATIONS)
(231) 360-0183
Entity
Organization
Contact information
Practice address
4100 PARK FOREST DR STE 200, TRAVERSE CITY, MI 49684-7306
(231) 600-7466
Mailing address
4290 COPPER RIDGE DR STE 110, TRAVERSE CITY, MI 49684-7208
(231) 421-8505
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
—
—
208800000X
Urology Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/26/2022
Last updated
04/09/2025
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