Provider Demographics
NPI:1386682847
Name:KOVACH, MELISSA MARIE (PA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:KOVACH
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:5413 US HIGHWAY 117 N
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27863-9445
Mailing Address - Country:US
Mailing Address - Phone:919-242-5271
Mailing Address - Fax:919-242-5096
Practice Address - Street 1:203 COX BLVD
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-9479
Practice Address - Country:US
Practice Address - Phone:919-508-0000
Practice Address - Fax:919-587-9086
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2021-03-31
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Provider Licenses
StateLicense IDTaxonomies
NC102633363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCS65784Medicare UPIN