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General NPI Number Information
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NPI Number | 1932849809
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Entity Type | Individual
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Provider Name | MATTHEW WILLIAM NOVAK DPM
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Gender | Male
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Dates
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Enumeration Date | 03/30/2022
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 3035 HAMILTON MASON RD STE 105
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City | FAIRFIELD TOWNSHIP
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State | OH
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Zip | 45011-5545
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Country | US
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Telephone | 513-844-8585
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Fax | 513-844-8769
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Provider Business Mailing Address
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Address Line | PO BOX 25592
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City | NEW YORK
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State | NY
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Zip | 10087-6951
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Country | US
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Telephone | 708-424-3201
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Fax | 708-424-5001
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 36.004196
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License Number State | OH
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