Individual
DR. MATTHEW JOHN NOVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
208 HOSPITAL PKWY, MOUNT VERNON, WA 98274
(360) 428-2550
(360) 814-8390
Mailing address
1400 E KINCAID ST, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD60878072
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02985266
—
NY
05
—
1021675260001
—
PA
05
—
2107794
—
WA
01
—
GU040072
PA MEDICARE GROUP
PA
Enumeration date
11/28/2007
Last updated
11/05/2018
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