Provider Demographics
NPI:1033191952
Name:KOVAC, MICHAEL JOHN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:KOVAC
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 SPOTNAP RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8812
Mailing Address - Country:US
Mailing Address - Phone:434-244-8412
Mailing Address - Fax:434-244-8415
Practice Address - Street 1:183 SPOTNAP RD
Practice Address - Street 2:SUITE C
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8812
Practice Address - Country:US
Practice Address - Phone:434-244-8412
Practice Address - Fax:434-244-8415
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101028090207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA229990OtherSOUTHERN HEALTH
VA367137OtherALLIANCE INS CO
VA5060072OtherCIGNA INS. CO.
VA367137OtherMAMSI INS. CO.
VA14107OtherCHIR INS. CO.
VAP00090532OtherMEDICARE RAILROAD
VA102221OtherANTHEM INS. CO.
VAB09503Medicare UPIN
VA003948C52Medicare ID - Type Unspecified