Provider Demographics
NPI:1215074893
Name:COVINGTON, NANCY (MD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:COVINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11390 OLD ROSWELL RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-2058
Mailing Address - Country:US
Mailing Address - Phone:678-708-4768
Mailing Address - Fax:866-240-2442
Practice Address - Street 1:11390 OLD ROSWELL RD STE 100
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-2058
Practice Address - Country:US
Practice Address - Phone:678-708-4768
Practice Address - Fax:866-240-2442
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030290207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA84457Medicare UPIN