MEDICARE: DR. DAVID M. NOVICK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	57641	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	300042737	OTHER	MA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01Y008541MA01	OTHER	NH	NH BLUE SHIELD ANTHEM
2	246301	OTHER	MA	HARVARD PILGRIM HEALTHCAR
3	38758	OTHER	MA	HEALTHY START
4	11087196	OTHER	MA	CAQH #
5	113710	OTHER	MD	AETNA/US HEALTHCARE
6	712670	OTHER	MA	TUFTS HEALTH PLAN
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	J06260	OTHER	MA	BLUE CROSS/BLUE SHIELD
11	6725467	OTHER	MA	CIGNA
12	916732	OTHER	MA	FIRST HEALTH & CCN
13	991461	OTHER	MA	NETWORK HEALTH
14	62021	OTHER	MA	FALLON

General Provider Information

NPI Number	:	1841285434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID M. NOVICK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 615
Second Line	:	L&M RADIOLOGY, INC.
City	:	ACTON
State	:	MA
Zip	:	01720-0615
Country	:	US
Telephone Number	:	978-266-2676
Fax Number	:	978-266-2680

Provider Business Practice Location Address
First Line	:	1 GENERAL ST
Second Line	:	LAWRENCE GENERAL HOSPITAL
City	:	LAWRENCE
State	:	MA
Zip	:	01841-2961
Country	:	US
Telephone Number	:	978-946-8103
Fax Number	:	978-946-8067

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	09/26/2017

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