Provider Demographics
NPI:1487636791
Name:NOVY, ANGELA M (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:NOVY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 CENTER ST
Mailing Address - Street 2:MILLER BLDG SUITE C
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-4063
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:934 CENTER ST
Practice Address - Street 2:MILLER BUILDING SUITE C
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-4063
Practice Address - Country:US
Practice Address - Phone:419-281-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH83371207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2454964Medicaid
OHNO4119942Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER
OH2454964Medicaid
H96483Medicare UPIN