Basic Information
| Provider Information | |||||||||
| NPI: | 1760846729 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NOVICK | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | EDWARDS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | EDWARDS | ||||||||
| OtherFirstName: | ELIZABETH | ||||||||
| OtherMiddleName: | LEIGH | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3800 RESERVOIR RD NW | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200072113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2024448168 | ||||||||
| FaxNumber: | 8773031460 | ||||||||
| Practice Location | |||||||||
| Address1: | 3800 RESERVOIR RD NW | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200072113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2024448168 | ||||||||
| FaxNumber: | 8773031460 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2016 | ||||||||
| LastUpdateDate: | 07/07/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 0101266683 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.