Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 38031 | NC |
NPI | 1154305878 |
---|---|
Provider Name | Wesley Covitz |
First Address | Winston Salem, NC 27102-0344 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 24/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2000323000 | (05) | WV |
24756 | BCBS (01) | NC |
2686 | PARTNERS (01) | NC |
35426 | MEDCOST (01) | NC |
4566823 | AETNA (01) | NC |
6712550 | (05) | VA |
8924756 | (05) | NC |
906951 | (05) | SC |
D29196 | (02) |