Individual
MR. MARC JEFFREY NOVOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8989 N PORT WASHINGTON ROAD, SUITE 122, MILWAUKEE, WI 53217
(414) 351-6250
(414) 351-6465
Mailing address
10503 N STRATFORD PLACE, MEQUON, WI 53092
(262) 242-0155
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
21059020
WI
2084N0400X
Neurology Physician
31417
AZ
2084N0400X
Neurology Physician
47442
MN
2084N0400X
Neurology Physician
ME88701
FL
Other
Enumeration date
07/09/2006
Last updated
07/12/2010
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