Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 24320 | WI |
NPI | 1366472524 |
---|---|
Provider Name | Edward H. Kovnar |
First Address | Milwaukee, WI 53209-2042 |
Second Address | Milwaukee, WI 53209-2042 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 02/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1366472524 | (05) | WI |
30463000 | (05) | WI |
F31152 | (02) | WI |