Provider Demographics
NPI:1356302855
Name:NOVAK, VICTOR F II (MD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:F
Last Name:NOVAK
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 S PLEASANT AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-2188
Mailing Address - Country:US
Mailing Address - Phone:814-445-2123
Mailing Address - Fax:
Practice Address - Street 1:223 S PLEASANT AVE STE 302
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-2188
Practice Address - Country:US
Practice Address - Phone:814-445-2123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD040142L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014264060001Medicaid
PA504994Medicare PIN
PA0014264060001Medicaid