Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | A88959 | CA |
Y | 207X00000X | Orthopaedic Surgeon | MD60001018 | WA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD60001018 | WA |
NPI | 1174648703 |
---|---|
Provider Name | Dr. Erik J Novak |
First Address | Seattle, WA 98104-1172 |
Second Address | Renton, WA 98055-5773 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 07/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
19456 | (02) |