Individual
MEGAN THERESA NOVIKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3200 SILVER STREET, HMS SHS WELLNESS CENTER, SILVER CITY, NM 88061-7283
(575) 388-1511
(575) 542-2388
Mailing address
530 DE MOSS STREET, HIDALGO MEDICAL SERVICES, LORDSBURG, NM 88045-2618
(575) 542-8384
(575) 542-2388
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
165097
OR
363AM0700X
Medical Physician Assistant
Primary
PA2015-0013
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60902230
—
NM
Enumeration date
10/16/2013
Last updated
01/11/2017
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