| Novus Health And Wellness | |
|
4808 Munson St Nw Canton OH 44718 | |
| (330) 830-8666 | |
| (330) 832-3499 |
| Full Name | Novus Health And Wellness |
|---|---|
| Speciality | Internal Medicine |
| Location | 4808 Munson St Nw, Canton, Ohio |
| Authorized Official Name and Position | Jyothi Dyavanapalli Gudla (PRESIDENT) |
| Authorized Official Contact | 3308308666 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Novus Health And Wellness 4808 Munson St Nw Canton OH 44718-3613 Ph: (330) 830-8666 | Novus Health And Wellness 4808 Munson St Nw Canton OH 44718 Ph: (330) 830-8666 |
| NPI Number | 1124259536 |
|---|---|
| Provider Enumeration Date | 08/03/2009 |
| Last Update Date | 05/22/2018 |
| Medicare PECOS PAC ID | 7618022849 |
|---|---|
| Medicare Enrollment ID | O20090911000162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124259536 | NPI | - | NPPES |
| 2940956 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 35-083145 (Ohio) | Primary |
| Provider Name | Jyothi Gudla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194872713 PECOS PAC ID: 1254318975 Enrollment ID: I20090707000248 |
| Provider Name | Lora Karg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275179129 PECOS PAC ID: 8921436304 Enrollment ID: I20200318000654 |
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