Provider Demographics
NPI:1336330356
Name:NOVECK, ROBERT JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:NOVECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 TRENT AVE.
Mailing Address - Street 2:DUKE UNIVERSITY SCHOOL OF MEDICINE, DCRU, DHS
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:07753-4476
Mailing Address - Country:US
Mailing Address - Phone:919-684-1018
Mailing Address - Fax:
Practice Address - Street 1:200 TRENT AVE.
Practice Address - Street 2:DUKE UNIVERSITY SCHOOL OF MEDICINE, DCRU, DHS
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710
Practice Address - Country:US
Practice Address - Phone:919-684-1018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.01677208U00000X
NJ25MA07996100208U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208U00000XAllopathic & Osteopathic PhysiciansClinical Pharmacology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA50004OtherMEDICARE
LA1350095Medicaid
LAB62133Medicare UPIN