Individual
DIANE M KOVACHIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
95 ARCH ST, #165, AKRON, OH 44304-1437
(330) 375-4848
(330) 376-4066
Mailing address
320 W EXCHANGE ST, AKRON, OH 44302-1709
(330) 535-4428
(330) 535-4451
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50-000807
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0067361
—
OH
01
—
1841239274
PARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH
01
—
2551671
PARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OH
01
—
9338635
PARTNERS PHYSICIAN GROUP MEDICARE GROUP #
OH
Enumeration date
02/02/2007
Last updated
04/18/2016
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