Provider Demographics
NPI:1356383624
Name:KOVACS, ATTILA (MD)
Entity type:Individual
Prefix:DR
First Name:ATTILA
Middle Name:
Last Name:KOVACS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-362-1291
Mailing Address - Fax:314-362-4278
Practice Address - Street 1:12634 OLIVE BLVD
Practice Address - Street 2:DIV IM CARDIOLOGY
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6337
Practice Address - Country:US
Practice Address - Phone:314-362-1291
Practice Address - Fax:314-362-4278
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO105828207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207633819Medicaid
MO207633827Medicaid
MO122011735Medicare PIN
MO470000938Medicare PIN
MO990010183Medicare PIN
MO000093029Medicare PIN
MO228010183Medicare PIN
MO122011735Medicaid
MO060034154Medicare PIN