Individual
TASHA KOUVATSOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
211 S 9TH ST, SUITE 600, PHILADELPHIA, PA 19107-6810
(215) 955-1925
(215) 928-3160
Mailing address
211 S 9TH ST, SUITE 600, PHILADELPHIA, PA 19107-6810
(215) 955-1925
(215) 928-3160
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD446082
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0472743
—
NJ
Enumeration date
05/08/2009
Last updated
09/11/2015
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