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Individual

NED R. NOVSAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6308 8TH AVE, SUITE 503, KENOSHA, WI 53143-5031
(262) 656-8213
(262) 656-8233
Mailing address
6308 8TH AVE, SUITE 503, KENOSHA, WI 53143-5031
(262) 656-8213
(262) 656-8233

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0030072
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31494300
WI
Enumeration date
07/05/2006
Last updated
12/11/2009
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