Provider Demographics
NPI:1558306530
Name:NOVEY, WALTER L (MD)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:L
Last Name:NOVEY
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 1:27 INSPIRATION DR
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-7327
Mailing Address - Country:US
Mailing Address - Phone:207-441-3371
Mailing Address - Fax:
Practice Address - Street 1:27 INSPIRATION DR
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7327
Practice Address - Country:US
Practice Address - Phone:207-441-3371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME015935207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEF67140Medicare UPIN
MEMM9595Medicare ID - Type Unspecified