Individual
EDWIN A NOVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
705 PLEASANT AVE S, PARK RAPIDS, MN 56470-1440
(218) 732-2800
(218) 732-2874
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(218) 732-2800
(218) 732-2874
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8935
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0111296
MEDICA #
MN
01
—
0111297
MEDICA #
MN
01
—
0121199
MEDICA #
MN
05
—
022387500
—
MN
01
—
121640
UCARE #
MN
05
—
1750328563
—
MN
01
—
18231
NDBS #
MN
01
—
73A11NO
MNBS #
MN
01
—
73A13NO
MNBS #
MN
01
—
975261
AMERICA'S PPO/ARAZ #
MN
01
—
DA9041015688
PREFERRED ONE #
MN
01
—
HP25821
HEALTHPARTNERS #
MN
Enumeration date
06/01/2006
Last updated
07/23/2012
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