Provider Demographics
NPI:1255463683
Name:KOVACH, STEPHEN JOHN III (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JOHN
Last Name:KOVACH
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:3400 CIVIC CENTER BLVD
Mailing Address - Street 2:1ST FLOOR EAST PAVILLION
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5161
Mailing Address - Country:US
Mailing Address - Phone:215-662-7300
Mailing Address - Fax:215-349-5895
Practice Address - Street 1:3400 CIVIC CENTER BLVD
Practice Address - Street 2:1ST FLOOR EAST PAVILLION
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5161
Practice Address - Country:US
Practice Address - Phone:215-662-7300
Practice Address - Fax:215-349-5895
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2020-12-22
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Provider Licenses
StateLicense IDTaxonomies
PAMD432250208200000X, 208600000X
NC200400697208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery