Provider Demographics
NPI:1821288051
Name:BODONYI-KOVACS, GABOR (MD)
Entity Type:Individual
Prefix:
First Name:GABOR
Middle Name:
Last Name:BODONYI-KOVACS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GABOR
Other - Middle Name:
Other - Last Name:BODONYI KOVACS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:75 CLAREMONT ST STE H
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3500
Mailing Address - Country:US
Mailing Address - Phone:406-752-7406
Mailing Address - Fax:406-752-7544
Practice Address - Street 1:75 CLAREMONT ST STE H
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3500
Practice Address - Country:US
Practice Address - Phone:406-752-7406
Practice Address - Fax:406-752-7544
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD044757207RN0300X
MT60924207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE200632530AMedicaid
NENA1229001Medicare PIN