Healthcare Provider Details

I. General information

NPI: 1992933865
Provider Name (Legal Business Name): NOVA MEDICAL ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 06/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2991 CROUSE LN
BURLINGTON NC
27215-8833
US

IV. Provider business mailing address

2991 CROUSE LN
BURLINGTON NC
27215-8833
US

V. Phone/Fax

Practice location:
  • Phone: 336-586-0994
  • Fax: 336-586-9363
Mailing address:
  • Phone: 336-586-0994
  • Fax: 336-586-9363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNC

VIII. Authorized Official

Name: SAADAT ALI KHAN
Title or Position: OWNER
Credential: MD
Phone: 336-586-0994