Provider Demographics
NPI:1346672730
Name:KOVACS, DAVE (RRT,RN)
Entity Type:Individual
Prefix:
First Name:DAVE
Middle Name:
Last Name:KOVACS
Suffix:
Gender:M
Credentials:RRT,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 CUNARD ST
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:OH
Mailing Address - Zip Code:43321-9705
Mailing Address - Country:US
Mailing Address - Phone:740-360-9091
Mailing Address - Fax:
Practice Address - Street 1:239 CUNARD ST
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:OH
Practice Address - Zip Code:43321-9705
Practice Address - Country:US
Practice Address - Phone:740-360-9091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH310533163WC0200X
OH71652279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care