Organization
NOVUS HEALTH AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JYOTHI DYAVANAPALLI GUDLA MD (PRESIDENT)
(330) 830-8666
Entity
Organization
Contact information
Practice address
4808 MUNSON ST NW, CANTON, OH 44718
(330) 830-8666
(330) 832-3499
Mailing address
4808 MUNSON ST NW, CANTON, OH 44718-3613
(330) 830-8666
(330) 832-3499
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
04/06/2016
Last updated
05/22/2018
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