Individual
DR. LUCAS W KONOVALENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
935 TRANCAS ST STE 4B, NAPA, CA 94558-2943
(707) 346-4444
(877) 354-4771
Mailing address
935 TRANCAS ST STE 4B, NAPA, CA 94558-2943
(707) 346-4444
(877) 354-4771
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4301089987
MI
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A135704
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0412253
BCBS PIN
MI
Enumeration date
07/02/2007
Last updated
03/15/2024
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