Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 34-007858 | OH |
NPI | 1013913979 |
---|---|
Provider Name | Jennifer L Cova |
First Address | Centerville, OH 45458-3439 |
Second Address | Centerville, OH 45458-3439 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2005 |
Last Update Date | 02/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2479241 | (05) | OH |
H12181 | (02) | OH |
H199541 | MEDICARE PTAN (01) | OH |