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NPI Code Detail

MEDICARE: DR. WILLIAM JOSEPH NOVELLI JR. MD, MPH

MEDICARE:  DR. WILLIAM JOSEPH NOVELLI JR. MD, MPH
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
1207R00000XInternal Medicine PhysicianCA40591CA
2207R00000XInternal Medicine PhysicianF9887TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679571319
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM JOSEPH NOVELLI JR. MD, MPH
Provider Business Mailing Address
First Line : 1509 S HIGHWAY 69
Second Line :
City : NEDERLAND
State : TX
Zip : 77627-7807
Country : US
Telephone Number : 409-722-9355
Fax Number : 409-420-1002
Provider Business Practice Location Address
First Line : 1509 S HIGHWAY 69
Second Line :
City : NEDERLAND
State : TX
Zip : 77627-7807
Country : US
Telephone Number : 409-722-9355
Fax Number : 409-420-1002
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 06/03/2014

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