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NOVICK, MARK DOUGLAS       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: BLUE RADIOLOGY
10101 FOREST HILL BLVE
WELLINGTON FL 33414-6103

Address last updated on 7/26/2024
Phone #: (516) 659-9600
Fax #: (516) 977-3322
County: NOT OKLAHOMA
License: 30893
Dated: 8/22/2014
Expires: 8/1/2025
Temp. Lic. Issued: 8/8/2014
Temp. Lic. Expires: 11/6/2014
License Type: Medical Doctor
Specialty: Diagnostic Radiology
Neuroradiology
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: UNIV OF TN, HLTH SCI CTR, COLL OF MED, MEMPHIS TN 38163
Graduated: 12 / 1978
CME Year: 2026
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF RADIOLOGY (Diagnostic Radiology specific)
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
BLUE RADIOLOGY
10101 FOREST HILL BLVE
WELLINGTON FL 33414-6103

Phone #: (516) 659-9600
Fax #: (516) 977-3322
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:

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