Organization
NORTHEAST INDIANA ANESTHESIOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KARYN KOVACH (DIRECTOR OF BILLING)
(419) 531-8808
Entity
Organization
Contact information
Practice address
353 N OAK ST, COLUMBIA CITY, IN 46725-1623
(260) 248-9304
Mailing address
2914 S REPUBLIC BLVD, TOLEDO, OH 43615-1912
(419) 531-8808
(419) 531-8877
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200366600A
—
IN
05
—
200366600B
—
IN
05
—
200366600C
—
IN
01
—
CJ6762
RAILROAD MEDICARE
IN
Enumeration date
06/08/2006
Last updated
06/18/2008
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