Individual
TERESA F KOVARIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2500 COMO AVE, MAIL STOP 31100A, ST PAUL, MN 55108-1460
(651) 641-6200
(651) 641-6205
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
34620
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
480808800
—
MN
Enumeration date
02/02/2006
Last updated
06/28/2021
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