Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 34-011410 | OH |
N | 2080P0204X | Pediatric Emergency Doctor | 34-011410 | OH |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 02005342A | IN |
NPI | 1265728695 |
---|---|
Provider Name | Dr. Scott Coven |
First Address | Indianapolis, IN 46206-1026 |
Second Address | Indianapolis, IN 46202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2011 |
Last Update Date | 11/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0204836 | (05) | OH |
300014553 | (05) | IN |