Individual
PAUL JEROME KOVALCIK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3105 AMERICAN LEGION ROAD, SUITE A, CHESAPEAKE, VA 23321-5653
(757) 686-2687
(757) 484-1682
Mailing address
3105 AMERICAN LEGION ROAD, SUITE A, CHESAPEAKE, VA 23321-5653
(757) 686-2687
(757) 484-1682
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
0101032355
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5834961
—
VA
Enumeration date
01/24/2006
Last updated
07/08/2007
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