Provider Demographics
NPI:1508834110
Name:NOVAK, CHRISTOPHER PHILIP (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:PHILIP
Last Name:NOVAK
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 LETRADO ST STE D
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4146
Mailing Address - Country:US
Mailing Address - Phone:505-476-2670
Mailing Address - Fax:505-476-2694
Practice Address - Street 1:605 LETRADO ST STE D
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4146
Practice Address - Country:US
Practice Address - Phone:505-476-2670
Practice Address - Fax:505-476-2694
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2009-00302083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM89387252Medicaid