Basic Information
Provider Information
NPI: 1568082550
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NOVEY
FirstName: WILL
MiddleName: BENJAMIN
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherLastNameType:  
Mailing Information
Address1: 101 MANNING DR CB# 7160
Address2:  
City: CHAPEL HILL
State: NC
PostalCode: 275992322
CountryCode: US
TelephoneNumber: 9849745217
FaxNumber:  
Practice Location
Address1: 101 MANNING DR BLDG 1
Address2:  
City: CHAPEL HILL
State: NC
PostalCode: 275144423
CountryCode: US
TelephoneNumber: 9849741000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/20/2020
LastUpdateDate: 02/03/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/03/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X2021-02342NCY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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