Individual
PETER A KOVALSZKI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
133 S MAIN ST, SUITE D, MOUNT CLEMENS, MI 48043-2308
(586) 465-1326
(586) 465-0329
Mailing address
133 S MAIN ST, SUITE D, MOUNT CLEMENS, MI 48043-2308
(586) 465-1326
(586) 465-0329
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301052134
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267880
—
MI
Enumeration date
07/05/2005
Last updated
07/08/2007
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