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Individual

ALEXANDER P. KOVANKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
44 BIRCH ST, SUITE 200, DERRY, NH 03038-2752
(603) 421-9616
(603) 421-2451
Mailing address
44 BIRCH ST, SUITE 200, DERRY, NH 03038-2752
(603) 421-9616
(603) 421-2451

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16416
NH
207Q00000X
Family Medicine Physician
1920
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3095269
NH
01
P01303747
RAILROAD MEDICARE
NH
Enumeration date
08/05/2006
Last updated
06/16/2014
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