Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | MD13525 | OR |
NPI | 1023094299 |
---|---|
Provider Name | Dr. Peter A Kovach |
First Address | Springfield, OR 97477-8803 |
Second Address | Springfield, OR 97477-8803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2005 |
Last Update Date | 30/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
283374 | (05) | OR |
C91789 | (02) | OR |