Provider Demographics
NPI:1053680314
Name:BOVICH, MIRIAM E (PT)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:E
Last Name:BOVICH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20410 CENTURY BLVD
Mailing Address - Street 2:NRH REGIONAL REHAB - SUITE 215
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-1186
Mailing Address - Country:US
Mailing Address - Phone:301-540-6140
Mailing Address - Fax:301-540-5190
Practice Address - Street 1:1120 20TH ST NW STE 116
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3406
Practice Address - Country:US
Practice Address - Phone:202-416-2110
Practice Address - Fax:202-416-2011
Is Sole Proprietor?:No
Enumeration Date:2011-12-15
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD23883225100000X
VA23052100212251S0007X
DC8713232251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist