Individual
DR. TATIANA KOVTOUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2800 BLUE RIDGE RD STE 300, RALEIGH, NC 27607-6476
(919) 784-7874
Mailing address
2800 BLUE RIDGE RD STE 300, RALEIGH, NC 27607-6476
(919) 784-7874
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
051813
CT
208600000X
Surgery Physician
Primary
2019-00175
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200570500A
—
KS
Enumeration date
07/17/2008
Last updated
03/29/2021
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