Provider Demographics
NPI:1184664807
Name:NOVICK, JAMES STANLEY (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:STANLEY
Last Name:NOVICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10845 PHILADELPHIA RD
Mailing Address - Street 2:
Mailing Address - City:WHITE MARSH
Mailing Address - State:MD
Mailing Address - Zip Code:21162-1717
Mailing Address - Country:US
Mailing Address - Phone:410-335-0008
Mailing Address - Fax:410-335-3113
Practice Address - Street 1:7505 OSLER DR
Practice Address - Street 2:SUITE 501
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-7736
Practice Address - Country:US
Practice Address - Phone:410-321-4900
Practice Address - Fax:410-321-8070
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-PHYS-LIC-78836207RG0100X
MDD0023008207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0499-0001OtherCAREFIRST
GA100000459OtherRAILROAD MEDICARE
MD794271100OtherMEDICAL ASSISTANCE
DC0499-0001OtherCAREFIRT
MD277472OtherMEDICARE