JACOB ALEXANDER MARTIN NOVACK (NPI# 1669096111) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669096111 |
| Entity Type | Individual |
| Full Name | JACOB ALEXANDER MARTIN NOVACK |
| Credential | DO |
| Practice Address |
27351 Dequindre Rd Madison Heights MI 48071-3487 |
| Mailing Address |
26460 Belanger St Roseville MI 48066-3162 |
| Practice Telephone | 2489677000 |
| Mailing Telephone | 5862162615 |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2020-06-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
27351 DEQUINDRE RD |
| City | MADISON HEIGHTS |
| State | MI |
| Zip Code | 48071-3487 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235126996 | J Barry Rubin | Psychiatry & Neurology | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2005-09-28 |
| 1134743206 | Ani Mnatsakanian | Otolaryngology | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2020-06-03 |
| 1205459971 | Brentwood Oftedal | Student in an Organized Health Care Education/Training Program | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2020-05-28 |
| 1700409703 | Noorel Zia | Student in an Organized Health Care Education/Training Program | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2020-05-26 |
| 1790308047 | Nora Rader | Student in an Organized Health Care Education/Training Program | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2020-05-21 |
| 1861014680 | Kevin Conor Kenney | Student in an Organized Health Care Education/Training Program | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2020-05-14 |
| 1750902409 | Dean Balabanov | Student in an Organized Health Care Education/Training Program | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2020-05-05 |
| 1437770161 | Charles Rodarmor | Student in an Organized Health Care Education/Training Program | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2020-05-05 |
| 1194346106 | Elvin Chiang | Student in an Organized Health Care Education/Training Program | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2020-04-30 |
| 1396365425 | Kylie Smith | Student in an Organized Health Care Education/Training Program | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2020-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952918831 | United Medical Laboratory LLC | Clinical Medical Laboratory | 30675 Stephenson Hwy, Suite B, Madison Heights, MI 48071 | 2020-09-25 |
| 1033776372 | Terry Ky-sieu Tran | Student in an Organized Health Care Education/Training Program | 27351 Dequindre Rd., Madison Height, MI 48071 | 2019-05-22 |
| 1942865894 | Jordan Lee Stav | Student in an Organized Health Care Education/Training Program | Sjmo Emergency Medicine Residency Program, 27351 Dequindre Rd, Madison Heights, MI 48071 | 2019-05-07 |
| 1538624960 | Holistic Therapy Institute Physical Therapy, Inc. | Physical Therapist | 30201 Dequidre Rd Suite1, Madison Hts, MI 48071 | 2019-02-11 |
| 1720558216 | Kevin Luce | Physical Therapy Assistant | 1433 E 12 Mile Road, Madison Heights, MI 48071 | 2018-11-28 |
| 1861974297 | Olubunmi Oluremi Aluko | Physical Therapist | 1410 E.14 Mile Road, Madison Heights, MI 48071 | 2018-09-01 |
| 1558859579 | Leslie G Lafer, Dopllc | Obstetrics & Gynecology | 1437 E 12 Mile Road, Building D, Madison Heights, MI 48071 | 2018-04-25 |
| 1588161020 | Daniel Eugene Geer | Physical Therapist | 1410 E 14 Mile Road, Madison Heights, MI 48071 | 2018-04-11 |
| 1881100931 | Medshop Pharmacy LLC | Pharmacy | 30549 Stephenson Hwy Ste B, Madison Heights, MI 48071 | 2017-12-26 |
| 1730602004 | Ali Bazzy | Nurse Practitioner | 27483 Dequindre Suite 304, Madison Hgts, MI 48071 | 2017-07-19 |
| Find all providers in zip 48071 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942865894 | Jordan Lee Stav | Student in an Organized Health Care Education/Training Program | Sjmo Emergency Medicine Residency Program, 27351 Dequindre Rd, Madison Heights, MI 48071 | 2019-05-07 |
| 1093147829 | John Blankenship | Student in an Organized Health Care Education/Training Program | 109 Lyttleton Ln, Madison Heights, VA 24572-2315 | 2013-08-03 |
| 1205459971 | Brentwood Oftedal | Student in an Organized Health Care Education/Training Program | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2020-05-28 |
| 1700409703 | Noorel Zia | Student in an Organized Health Care Education/Training Program | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2020-05-26 |
| 1790308047 | Nora Rader | Student in an Organized Health Care Education/Training Program | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2020-05-21 |
| 1861014680 | Kevin Conor Kenney | Student in an Organized Health Care Education/Training Program | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2020-05-14 |
| 1851913362 | Sarah King | Student in an Organized Health Care Education/Training Program | 27483 Dequindre Rd Ste 301, Madison Heights, MI 48071-5715 | 2020-05-07 |
| 1750902409 | Dean Balabanov | Student in an Organized Health Care Education/Training Program | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2020-05-05 |
| 1437770161 | Charles Rodarmor | Student in an Organized Health Care Education/Training Program | 27351 Dequindre Rd, Madison Heights, MI 48071-3487 | 2020-05-05 |
| 1750902649 | Sonal Guruprasad Vijayanagar | Student in an Organized Health Care Education/Training Program | 27483 Dequindre Rd Ste 301, Madison Heights, MI 48071-5715 | 2020-05-01 |
| Find all providers in MADISON HEIGHTS | ||||
| City | MADISON HEIGHTS |
| Zip Code | 48071 |
Please comment or provide details below to improve the information on JACOB ALEXANDER MARTIN NOVACK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.