Individual
MICHAEL T KOVALCHIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
780 LITCHFIELD ST, SUITE200, TORRINGTON, CT 06790-6268
(860) 489-1984
(860) 496-2195
Mailing address
780 LITCHFIELD ST, SUITE200, TORRINGTON, CT 06790-6268
(860) 489-1984
(860) 496-2195
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
020094
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00120094800
ANTHEM FAMILY
—
01
—
010020094CT01
ANTHEM
—
01
—
040477
HEALTH NET
—
05
—
1200948
—
CT
01
—
539143
AETNA
—
01
—
752466
CONNECTICARE
—
01
—
P3600333
OXFORD
—
Enumeration date
12/14/2005
Last updated
12/03/2009
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