Provider Demographics
NPI:1295894582
Name:DAVID A. NOVOTNY M D, INC
Entity type:Organization
Organization Name:DAVID A. NOVOTNY M D, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:NOVOTNY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-934-2770
Mailing Address - Street 1:36855 AMERICAN WAY
Mailing Address - Street 2:SUITE 2D
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-4045
Mailing Address - Country:US
Mailing Address - Phone:440-934-2770
Mailing Address - Fax:440-934-2774
Practice Address - Street 1:36855 AMERICAN WAY
Practice Address - Street 2:SUITE 2D
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-4045
Practice Address - Country:US
Practice Address - Phone:440-934-2770
Practice Address - Fax:440-934-2774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty