Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 40765 | SC |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | ME122245 | FL |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | Q7938 | TX |
N | 207YS0123X | Facial Plastic Surgeon | ME122245 | FL |
NPI | 1427377076 |
---|---|
Provider Name | Sarah Jane Novis |
First Address | Florence, SC 29502-3239 |
Second Address | Little River, SC 29566-8165 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2010 |
Last Update Date | 15/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
014937100 | (05) | FL |
150NA | BLUE CROSS BLUE SHIELD (01) | FL |
407651 | (05) | SC |