Provider Demographics
NPI:1215932512
Name:KOVACH, CHAU N (MD)
Entity type:Individual
Prefix:DR
First Name:CHAU
Middle Name:N
Last Name:KOVACH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHAU-THUONG
Other - Middle Name:T
Other - Last Name:NGUYEN-DANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8200 W CENTRAL AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-3661
Mailing Address - Country:US
Mailing Address - Phone:316-722-6260
Mailing Address - Fax:316-721-8307
Practice Address - Street 1:929 N SAINT FRANCIS ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214
Practice Address - Country:US
Practice Address - Phone:316-268-5000
Practice Address - Fax:316-291-4396
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0429856207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100450290DMedicaid
KS110173070Medicare PIN