Provider Demographics
NPI:1932118361
Name:NOVIS, ELMER (MD)
Entity Type:Individual
Prefix:MR
First Name:ELMER
Middle Name:
Last Name:NOVIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1540 LAKE LANSING RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3756
Mailing Address - Country:US
Mailing Address - Phone:517-913-3810
Mailing Address - Fax:517-913-3911
Practice Address - Street 1:1540 LAKE LANSING RD
Practice Address - Street 2:SUITE 102
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3756
Practice Address - Country:US
Practice Address - Phone:517-913-3810
Practice Address - Fax:517-913-3911
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2011-01-17
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Provider Licenses
StateLicense IDTaxonomies
MI4301045362207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7308733OtherAETNA
MI0M21440075OtherMEDICARE ADVANTAGE
MI0103302542OtherBLUE CARE NETWORK
MI1053972OtherMCLAREN HEALTH ADVANTAGE
MI0103302542OtherBLUE CROSS BLUE SHIELD
MI1053972OtherMCLAREN HEALTH PLAN-COMMERCIAL
MIP00874182OtherRAILROAD MEDICARE
MI1053972OtherMCLAREN HEALTH PLAN-MEDICAID
MI1053972OtherMCLAREN HEALTH ADVANTAGE
MI1053972OtherMCLAREN HEALTH PLAN-COMMERCIAL