Basic Information
| Provider Information | |||||||||
| NPI: | 1427377076 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NOVIS | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | JANE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3239 | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295023239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8433663040 | ||||||||
| FaxNumber: | 8433663041 | ||||||||
| Practice Location | |||||||||
| Address1: | 3980 HIGHWAY 9 E STE 340 | ||||||||
| Address2: | |||||||||
| City: | LITTLE RIVER | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295668165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8433663040 | ||||||||
| FaxNumber: | 8433663041 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2010 | ||||||||
| LastUpdateDate: | 02/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207YS0123X | ME122245 | FL | N | Allopathic & Osteopathic Physicians | Otolaryngology | Facial Plastic Surgery | 207Y00000X | 40765 | SC | Y | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | Q7938 | TX | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | ME122245 | FL | N | Allopathic & Osteopathic Physicians | Otolaryngology |
ID Information
| ID | Type | State | Issuer | Description | 150NA | 01 | FL | BLUE CROSS BLUE SHIELD | OTHER | 014937100 | 05 | FL | MEDICAID | 407651 | 05 | SC | MEDICAID |