Provider Demographics
NPI:1457772196
Name:COVERT, MARGARET ROSE
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ROSE
Last Name:COVERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:ROSE
Other - Last Name:TERRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RCS
Mailing Address - Street 1:206 TESSING CT
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-7587
Mailing Address - Country:US
Mailing Address - Phone:314-304-2364
Mailing Address - Fax:
Practice Address - Street 1:206 TESSING CT
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060-7587
Practice Address - Country:US
Practice Address - Phone:314-304-2364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-25
Last Update Date:2013-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000852595171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor