Provider Demographics
NPI:1750599064
Name:NOVAK, BENJAMIN JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:JAMES
Last Name:NOVAK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:200 UNIVERSITY AVE E
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-2507
Mailing Address - Country:US
Mailing Address - Phone:651-602-3262
Mailing Address - Fax:651-312-3188
Practice Address - Street 1:200 UNIVERSITY AVE E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2507
Practice Address - Country:US
Practice Address - Phone:651-602-3262
Practice Address - Fax:651-312-3188
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2015-10-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN56666207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNH400096228Medicare UPIN