Provider Demographics
NPI:1487855177
Name:NOVAK, TROY ALAN (PA)
Entity Type:Individual
Prefix:MR
First Name:TROY
Middle Name:ALAN
Last Name:NOVAK
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:1447 N HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-4727
Mailing Address - Country:US
Mailing Address - Phone:989-463-3101
Mailing Address - Fax:989-463-2824
Practice Address - Street 1:1910 PINE AVE
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1298
Practice Address - Country:US
Practice Address - Phone:989-463-3101
Practice Address - Fax:989-463-2824
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601003445363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant