Provider Demographics
NPI:1205037918
Name:KOLOVRAT, FRANK JR
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:KOLOVRAT
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-1221
Mailing Address - Country:US
Mailing Address - Phone:910-687-4888
Mailing Address - Fax:
Practice Address - Street 1:2909 MARKET ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-1221
Practice Address - Country:US
Practice Address - Phone:910-687-4888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-11215363A00000X
NY024951363A00000X
FLPS 40903183500000X
WI3936-23363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No183500000XPharmacy Service ProvidersPharmacist