Organization
PORT HURON NEUROLOGIC ASSOCIATES P.C.
Active
Organization
PORT HURON NEUROLOGIC ASSOCIATES P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD RALPH KOVAR D.O. (PRESIDENT)
(810) 982-0100
Entity
Organization
Contact information
Practice address
3825 24TH AVE, FORT GRATIOT, MI 48059-4100
(810) 982-0100
(810) 982-0365
Mailing address
3825 24TH AVE, FORT GRATIOT, MI 48059-4100
(810) 982-0100
(810) 982-0365
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
5101011111
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3072470-11
—
MI
01
—
5740293
BCBS
MI
Enumeration date
03/19/2008
Last updated
10/29/2019
Update your record
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