Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 27007 | AZ |
NPI | 1023081783 |
---|---|
Provider Name | Dr. Sharon Ann Novy |
First Address | Gilbert, AZ 85233-5142 |
Second Address | Gilbert, AZ 85233-5129 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
465402 | (05) | AZ |
OTH000 | (02) | AZ |