Novak, Russell A

Novak, Russell A is an individual health care provider with primary practice located at 200 Theda Clark Medical Plaza Suite 480, Neenah WI 54956. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Novak, Russell A can be contacted via phone (920) 729-0608.

Contact Information

Primary practice address
200 Theda Clark Medical Plaza Suite 480 Neenah WI 54956
Phone: (920) 729-0608
Fax: (920) 729-2902
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 48910 Wisconsin
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 48910 Wisconsin
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 197207 New York
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 48910 Wisconsin

Profile Details

NPI number 1558352211
LBN Legal business name Novak, Russell A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated Jan 30th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558352211 NPPES
Wisconsin MEDICAID 34826700

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