Provider Demographics
NPI:1083670632
Name:NOVAK, MELANIE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:MARIE
Last Name:NOVAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2845 SW CAPITAL AVE
Mailing Address - Street 2:STE206
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-4185
Mailing Address - Country:US
Mailing Address - Phone:269-223-7045
Mailing Address - Fax:269-282-0758
Practice Address - Street 1:2845 SW CAPITAL AVE
Practice Address - Street 2:STE206
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4185
Practice Address - Country:US
Practice Address - Phone:269-223-7045
Practice Address - Fax:269-282-0758
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301079437208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4507778OtherHUMANA
MI4544234-10Medicaid
MI130390OtherBCBS
MI4484593-10Medicaid
MI4544243-10Medicaid
MI4544234-10Medicaid