Provider Demographics
NPI:1972884724
Name:NOVECK, MARTIN ILAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:ILAN
Last Name:NOVECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9255 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-2726
Mailing Address - Country:US
Mailing Address - Phone:248-922-0446
Mailing Address - Fax:248-922-0448
Practice Address - Street 1:9255 ALLEN RD
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48348-2726
Practice Address - Country:US
Practice Address - Phone:248-922-0446
Practice Address - Fax:248-922-0448
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301045047207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine