Healthcare Provider Details

I. General information

NPI: 1033243639
Provider Name (Legal Business Name): ENRICO M NOVELLI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S GREENE ST
BALTIMORE MD
21201-1544
US

IV. Provider business mailing address

5150 CENTRE AVE UPMC CANCER PAVILION, ROOM 461
PITTSBURGH PA
15232-1309
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-8040
  • Fax: 410-328-2578
Mailing address:
  • Phone: 412-648-6431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0107262
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD424749
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: