Individual
EDWARD J NOVOTNY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4800 SAND POINT WAY NE, NEUROLOGY, M/S B-5552, SEATTLE, WA 98105-3901
(206) 987-2078
(206) 987-2649
Mailing address
4500 SAND POINT WAY NE, SUITE 100, M/S CUMG, PO BOX 359300, SEATTLE, WA 98105-3900
(206) 987-8540
(206) 987-8415
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
MD60078540
WA
2084N0600X
Clinical Neurophysiology Physician
MD60078540
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008549560
—
WA
05
—
001285578
—
CT
Enumeration date
11/22/2005
Last updated
07/23/2012
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