Provider Demographics
NPI:1265435820
Name:NOVAKOVIC, RACHEL L (MD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:L
Last Name:NOVAKOVIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2409 CHERRY STREET
Mailing Address - Street 2:MOB 303
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608
Mailing Address - Country:US
Mailing Address - Phone:419-251-4674
Mailing Address - Fax:419-251-3862
Practice Address - Street 1:2409 CHERRY STREET
Practice Address - Street 2:MOB 303
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608
Practice Address - Country:US
Practice Address - Phone:419-251-4674
Practice Address - Fax:419-251-3862
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35071444N2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
02937OtherPARAMOUNT
1701443OtherUNITED HEALTH CARE
OH2032875Medicaid
2450445006OtherCIGNA
704774OtherFAMILY HEALTH PLAN
OH020052295OtherRAILROAD MEDICARE
2032875OtherBUCKEYE COMMUNITY HEALTH PLAN
000000223900OtherANTHEM
26387OtherNATIONWIDE
5445556OtherAETNA
MI104389727OtherMICHIGAN MEDICAID
26387OtherNATIONWIDE
5445556OtherAETNA
OH020052295OtherRAILROAD MEDICARE
02937OtherPARAMOUNT
5445556OtherAETNA