| Charles C Novak Md Chartered | |
|
413 N Allumbaugh St Ste 101 Boise ID 83704-9219 | |
| (208) 323-1125 | |
| Not Available |
| Full Name | Charles C Novak Md Chartered |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 413 N Allumbaugh St Ste 101, Boise, Idaho |
| Authorized Official Name and Position | Alison Dunbar (BILLING SUPERVISOR) |
| Authorized Official Contact | 2083231125 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles C Novak Md Chartered 413 N Allumbaugh St Ste 101 Boise ID 83704-9219 Ph: (208) 323-1125 | Charles C Novak Md Chartered 413 N Allumbaugh St Ste 101 Boise ID 83704-9219 Ph: (208) 323-1125 |
| NPI Number | 1316245004 |
|---|---|
| Provider Enumeration Date | 03/04/2011 |
| Last Update Date | 03/04/2011 |
| Medicare PECOS PAC ID | 5597948034 |
|---|---|
| Medicare Enrollment ID | O20110322000282 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316245004 | NPI | - | NPPES |
| 1770511743 | Other | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | M4922 (Idaho) | Primary |
| Provider Name | Charles C Novak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770511743 PECOS PAC ID: 0042261174 Enrollment ID: I20050207000568 |
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