Individual
ROBERT KOVACHEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
15900 W 101ST AVE, DYER, IN 46311
(219) 365-6333
(219) 365-8291
Mailing address
15900 W 101ST AVE, MARCOTTE MEDICAL GROUP, SC, DYER, IN 46311
(219) 365-6333
(219) 365-6333
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02002505A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000513385
ANTHEM
IN
05
—
200400350
—
IN
01
—
DE6640
RAILROAD
IN
01
—
P00462444
RAILROAD
IN
Enumeration date
02/13/2006
Last updated
04/08/2021
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