Healthcare Provider Details

I. General information

NPI: 1184664807
Provider Name (Legal Business Name): JAMES STANLEY NOVICK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7505 OSLER DR SUITE 501
BALTIMORE MD
21204-7736
US

IV. Provider business mailing address

10845 PHILADELPHIA RD
WHITE MARSH MD
21162-1717
US

V. Phone/Fax

Practice location:
  • Phone: 410-321-4900
  • Fax: 410-321-8070
Mailing address:
  • Phone: 410-335-0008
  • Fax: 410-335-3113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMED-PHYS-LIC-78836
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberD0023008
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: