| Glenn J. Novak D O Inc | |
|
51 Westchester Dr Youngstown OH 44515-3902 | |
| (330) 799-1718 | |
| (330) 799-8328 |
| Full Name | Glenn J. Novak D O Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 51 Westchester Dr, Youngstown, Ohio |
| Authorized Official Name and Position | Glenn Joseph Novak (PHYSICIAN) |
| Authorized Official Contact | 3307991718 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Glenn J. Novak D O Inc 51 Westchester Dr Youngstown OH 44515-3902 Ph: (330) 799-1718 | Glenn J. Novak D O Inc 51 Westchester Dr Youngstown OH 44515-3902 Ph: (330) 799-1718 |
| NPI Number | 1205155199 |
|---|---|
| Provider Enumeration Date | 05/18/2010 |
| Last Update Date | 05/24/2010 |
| Medicare PECOS PAC ID | 4082743323 |
|---|---|
| Medicare Enrollment ID | O20100526000137 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205155199 | NPI | - | NPPES |
| 0766434 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 03058 (Ohio) | Primary |
| Provider Name | Glenn Joseph Novak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750380788 PECOS PAC ID: 6608905849 Enrollment ID: I20100526000186 |
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