Healthcare Provider Details

I. General information

NPI: 1629051891
Provider Name (Legal Business Name): STEVEN J NOVACHECK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1637 ROBY RD
STOUGHTON WI
53589-1274
US

IV. Provider business mailing address

1637 ROBY RD
STOUGHTON WI
53589-1274
US

V. Phone/Fax

Practice location:
  • Phone: 608-575-7554
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number21580020
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number21580
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: