Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2007-01506 | NC |
N | 111NI0900X | Internist | 2007-01506 | NC |
N | 207R00000X | Internist | 35994 | WI |
N | 111NI0900X | Internist | 35994 | WI |
Y | 207RH0002X | Hospice and Palliative Medicine | 2007-01506 | NC |
NPI | 1205802162 |
---|---|
Provider Name | Dr. Joseph Michael Kovaz |
First Address | Flat Rock, NC 28731-9447 |
Second Address | Flat Rock, NC 28731 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 22/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1531V | BCBS OF NC (01) | NC |
2007-01506 | MEDICAL DOCTOR (01) | |
32152900 | (05) | WI |
5911322 | (05) | NC |
AK8717449 | DEA (01) | NC |
D90622 | (02) |