Provider Demographics
NPI:1447469515
Name:NOVAK, CHRISTOPHER ERIC
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ERIC
Last Name:NOVAK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2390 W CONGRESS ST
Mailing Address - Street 2:QUALITY MANAGEMENT DEPT
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-4205
Mailing Address - Country:US
Mailing Address - Phone:337-261-6323
Mailing Address - Fax:337-261-6334
Practice Address - Street 1:2390 W CONGRESS ST
Practice Address - Street 2:QUALITY MANAGEMENT DEPT
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-4205
Practice Address - Country:US
Practice Address - Phone:337-261-6323
Practice Address - Fax:337-261-6334
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD201452207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine