Provider Demographics
NPI:1518072156
Name:NOVOSEL, TIMOTHY JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JAMES
Last Name:NOVOSEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 936857
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-6857
Mailing Address - Country:US
Mailing Address - Phone:910-662-9300
Mailing Address - Fax:910-662-2401
Practice Address - Street 1:1725 NEW HANOVER MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5345
Practice Address - Country:US
Practice Address - Phone:910-662-9300
Practice Address - Fax:910-662-2401
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232753208600000X, 2086S0102X
NC2018-01072208600000X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA-019OtherTRICARE/CHAMPUS
VAPAROtherVIRGINIA HEALTH NETWORK
VAPAROtherMULTIPLAN
VA10012521OtherSENTARA OPTIMA
NC2018-01072OtherMEDICAL LICENSE
VA221095OtherANTHEM
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherCORVEL/CORCARE
VA10012521OtherSENTARA OPTIMA
VAPAROtherMULTIPLAN
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA-019OtherTRICARE/CHAMPUS
VA221095OtherANTHEM
VAPAROtherVIRGINIA HEALTH NETWORK
VA-019OtherTRICARE/CHAMPUS
VAPAROtherAETNA
VAPAROtherVIRGINIA HEALTH NETWORK