Provider Demographics
NPI:1831354539
Name:KOVALESKI, AARON C (MD)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:C
Last Name:KOVALESKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:536 MEADOWLEAF LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-5712
Mailing Address - Country:US
Mailing Address - Phone:501-425-8489
Mailing Address - Fax:
Practice Address - Street 1:8080 PARK MEADOWS DR STE 150
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-2566
Practice Address - Country:US
Practice Address - Phone:720-668-8818
Practice Address - Fax:720-710-9492
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012607262085R0204X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000161370Medicaid
AR255670YH95Medicare PIN