Individual
DR. JOSE R NOVOA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
140 S 77TH ST, WORKFIT, OMAHA, NE 68114
(402) 934-4535
(402) 934-5939
Mailing address
140 S 77TH ST, OMAHA, NE 68114
(402) 934-4535
(402) 934-5939
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
17836
NE
2083X0100X
Occupational Medicine Physician
Primary
17836
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002475
RAILROAD MEDICARE - GRP
—
01
—
010051130
RAILROAD MEDICARE
—
05
—
0972984
—
IA
05
—
47064207113
—
NE
Enumeration date
05/11/2006
Last updated
08/13/2014
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