| Doctor Name: | MR. CHARLES WHEELER NOVAK |
| NPI Number: | 1144405580 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CRNP-PMH |
| License Number: | 0024168080 |
| Business Practice Address: | 12145 Elm St Princess Anne, MD - 218531358 |
| Business Phone Number: | 4106512204 |
| Business Fax Number: | 4106510790 |
| Mailing Address: | Po Box 1978, SALISBURY |
| State: | MD |
| Postal Code: | 218021978 |
| Phone Number: | 4107491015 |
| Fax Number: | 4107490654 |
| NPI Enumeration Date: | 01/03/2008 |
| NPI Last Update Date: | 03/14/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 0024168080 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |