Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | C10007640 | DE |
NPI | 1114982972 |
---|---|
Provider Name | George Kovalevsky |
First Address | Newark, DE 19713-2072 |
Second Address | Newark, DE 19713-2072 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H82584 | (02) | DE |