MEDICARE: JOSEPH NOVOSEL DPM

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	213E00000X	Podiatrist	0564	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00AM11	OTHER	TX	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669488128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH NOVOSEL DPM

Provider Business Mailing Address
First Line	:	2850 EASTEX FWY
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77703-4618
Country	:	US
Telephone Number	:	409-899-1340
Fax Number	:	409-899-5184

Provider Business Practice Location Address
First Line	:	2850 EASTEX FWY
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77703-4618
Country	:	US
Telephone Number	:	409-899-1340
Fax Number	:	409-899-5184

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	07/11/2008

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Directions to “ JOSEPH NOVOSEL DPM” Practice Location

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