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NOVELLO SPECIALTY CLINIC PC NPI 1629716964


NPI Information

NPI: 1629716964
Provider Name: NOVELLO SPECIALTY CLINIC PC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 23D2269939

Address:
4100 PARK FOREST DR STE 200
TRAVERSE CITY, MI
ZIP 49684
Phone: (231) 600-7466
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NOVELLO SPECIALTY CLINIC PC is a multi-specialty clinic center in Traverse City, MI. NOVELLO SPECIALTY CLINIC PC NPI is 1629716964. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4100 PARK FOREST DR STE 200
TRAVERSE CITY, MI
ZIP 49684-306
Phone: (231) 600-7466

The provider's authorized official is Kristen Elliott .
The authorized official title is Director, Operations and has the following contact phone number (231) 360-0183.

The CLIA number assigned to this NPI record is 23D2269939 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/26/2022 and was last updated on 8/15/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RR0500XInternal MedicineRheumatologyNo
2208800000XUrologyNo
3261QM1300XClinic/CenterMulti-SpecialtyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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