Provider Demographics
NPI:1902872674
Name:KOVALESKI, DAVID H (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:H
Last Name:KOVALESKI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2400 S. MINNESOTA AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-3762
Mailing Address - Country:US
Mailing Address - Phone:605-322-7510
Mailing Address - Fax:605-322-6475
Practice Address - Street 1:1325 S CLIFF AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1007
Practice Address - Country:US
Practice Address - Phone:605-322-2460
Practice Address - Fax:605-322-2470
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2013-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SD5391207RN0300X
SDS5391208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND12903Medicaid
SD4995328OtherBLUE CROSS
SDP00191474OtherRR MEDICARE
SD5391OtherDAKOTACARE
SD57105P007OtherWPS TRICARE
SDHP43042OtherHEALTHPARTNERS
SD36792OtherSANFORD HEALTH PLAN
IA37494OtherBLUE CROSS
MN704448800Medicaid
SD2235973OtherARAZ/ AMERICA'S PPO
SD243567OtherMIDLANDS CHOICE
SD3100230OtherMEDICA
SD6004880Medicaid
IA0581967Medicaid
MN296L1KOOtherBLUE CROSS
MN296L1KOOtherCC SYSTEMS/ BLUE PLUS
SD406751041580OtherPREFERRED ONE
NE46022474344Medicaid
SD406751041580OtherPREFERRED ONE
SD4995328OtherBLUE CROSS