Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 23499 | WV |
N | 207XS0106X | Orthopaedic Hand Surgeon | 01045773A | IN |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 23499 | WV |
NPI | 1336118991 |
---|---|
Provider Name | Steven R Novotny |
First Address | Huntington, WV 25701-3656 |
Second Address | Huntington, WV 25701-3656 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 18/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000193876 | ANTHEM PROVIDER NUMBER (01) | IN |
10825677 | CAQH NUMBER (01) | IN |
200119480 | (05) | IN |
2989057 | (05) | OH |
3810014348 | (05) | WV |
7100098070 | (05) | KY |
9397344 | PHCS PID NUMBER (01) | IN |
E78397 | (02) | IN |