Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 01039429A | IN |
N | 207RC0000X | Internist - Cardiovascular Disease | 01039429A | IN |
NPI | 1447221981 |
---|---|
Provider Name | Dr. David O Kovacich |
First Address | Greenwood, IN 46143-7241 |
Second Address | Indianapolis, IN 46237-6345 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 19/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100102190A | (05) | IN |
E92068 | (02) |