Provider Demographics
NPI:1154682540
Name:KOVACEVIC, RONALD JAMES (CRNA)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:JAMES
Last Name:KOVACEVIC
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:282 LOUTHAN RD
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:16115-3518
Mailing Address - Country:US
Mailing Address - Phone:724-827-8888
Mailing Address - Fax:
Practice Address - Street 1:1501 REEDSDALE ST
Practice Address - Street 2:SUITE 4004
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15233-2341
Practice Address - Country:US
Practice Address - Phone:412-204-0048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-03
Last Update Date:2012-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN500488L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered