MEDICARE: SARAH JANE NOVIS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207YS0123X	Facial Plastic Surgery Physician	ME122245	FL
2	207Y00000X	Otolaryngology Physician	40765	SC
3	207Y00000X	Otolaryngology Physician	Q7938	TX
4	207Y00000X	Otolaryngology Physician	ME122245	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	150NA	OTHER	FL	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427377076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH JANE NOVIS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 3239
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29502-3239
Country	:	US
Telephone Number	:	843-366-3040
Fax Number	:	843-366-3041

Provider Business Practice Location Address
First Line	:	3980 HIGHWAY 9 E STE 340
Second Line	:
City	:	LITTLE RIVER
State	:	SC
Zip	:	29566-8165
Country	:	US
Telephone Number	:	843-366-3040
Fax Number	:	843-366-3041

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2010
Last Update Date	:	02/15/2021

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Directions to “ SARAH JANE NOVIS M.D.” Practice Location

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