Individual
MICHEAL R COVAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1124 WEST 21ST STREET, ANDOVER, KS 67002
(316) 300-4000
Mailing address
7718 E OAKMOUNT ST, WICHITA, KS 67226-3527
(316) 315-0621
(316) 315-0621
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
04-30920
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200330190A
—
KS
Enumeration date
08/12/2005
Last updated
07/08/2007
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