Provider Demographics
NPI:1346218195
Name:NOVICK, CARA D (MD)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:D
Last Name:NOVICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 741593
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-1593
Mailing Address - Country:US
Mailing Address - Phone:757-668-8544
Mailing Address - Fax:757-668-6544
Practice Address - Street 1:171 KEMPSVILLE RD
Practice Address - Street 2:BUILDING A
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4700
Practice Address - Country:US
Practice Address - Phone:757-668-6550
Practice Address - Fax:757-668-6544
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80677207X00000X
VA0101249783207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1346218195OtherAETNA
VA1346218195OtherVA PREMIER
VA1346218195Medicaid
VA7540791OtherCIGNA
VA311610834OtherMDIPA
VA311610834OtherUHC
VA1346218195OtherANTHEM
VA1346218195OtherMULTIPLAN
VA1346218195OtherMEDICARE
VA311610834OtherBEECH STREET
VA311610834OtherMAMSI
VA311610834OtherVHN
VA10082054OtherOPTIMA
VA311610834OtherTRICARE
NC5918978Medicaid