Provider Demographics
NPI:1114122181
Name:NOVAKOVICH, MICHELLE ANNE (AUD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ANNE
Last Name:NOVAKOVICH
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 HUTTON LN
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7244
Mailing Address - Country:US
Mailing Address - Phone:336-884-5929
Mailing Address - Fax:336-884-4081
Practice Address - Street 1:1008 HUTTON LN
Practice Address - Street 2:SUITE 107
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7244
Practice Address - Country:US
Practice Address - Phone:336-884-5929
Practice Address - Fax:336-884-4081
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5289231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7001527Medicaid