Provider Demographics
NPI:1689744351
Name:NOVAK, JAMES EDMUND (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDMUND
Last Name:NOVAK
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2799 W GRAND BLVD, CFP-505
Mailing Address - Street 2:DIVISION OF NEPHROLOGY, HENRY FORD HEALTH SYSTEM
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202
Mailing Address - Country:US
Mailing Address - Phone:313-916-2710
Mailing Address - Fax:313-916-2554
Practice Address - Street 1:2799 W GRAND BLVD, CFP-505
Practice Address - Street 2:DIVISION OF NEPHROLOGY, HENRY FORD HEALTH SYSTEM
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202
Practice Address - Country:US
Practice Address - Phone:313-916-2710
Practice Address - Fax:313-916-2554
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2021-03-01
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Provider Licenses
StateLicense IDTaxonomies
MI4301080011207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology