Provider Demographics
NPI:1003802083
Name:DAVIS, NOVLET JARRETT (MD)
Entity Type:Individual
Prefix:MRS
First Name:NOVLET
Middle Name:JARRETT
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5109 SUNSET FAIRWAYS DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-7862
Mailing Address - Country:US
Mailing Address - Phone:336-740-2160
Mailing Address - Fax:919-443-1268
Practice Address - Street 1:875 WALNUT ST # 275-9
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4215
Practice Address - Country:US
Practice Address - Phone:919-749-6288
Practice Address - Fax:919-443-1268
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200400131207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC143MMOtherBCBS OF NC
NC5903674Medicaid
NC188813OtherMEDCOST
NC808427OtherPARTNERS
NC2053426Medicare PIN
NC5903674Medicaid
NC188813OtherMEDCOST