Provider Demographics
NPI:1992773451
Name:KOVAL, JOHN M (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:KOVAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7629 MARKET ST STE 200
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6082
Mailing Address - Country:US
Mailing Address - Phone:330-965-4540
Mailing Address - Fax:330-965-4559
Practice Address - Street 1:7641 MARKET ST STE 2
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-5980
Practice Address - Country:US
Practice Address - Phone:330-884-2444
Practice Address - Fax:330-965-4836
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2015-04-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35048160207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0514616Medicaid
A15391Medicare UPIN