Organization
MEDICAL REHABILITATION GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD JAY KOVAN M.D. (PHYSICIAN)
(810) 606-7181
Entity
Organization
Contact information
Practice address
4632 GENESYS PKWY, GRAND BLANC, MI 48439-8067
(810) 606-7181
(810) 606-5803
Mailing address
4632 GENESYS PKWY, GRAND BLANC, MI 48439-8067
(810) 606-7181
(810) 606-5803
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
4301055356
MI
208100000X
Physical Medicine & Rehabilitation Physician
4301072856
MI
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5101011645
MI
208100000X
Physical Medicine & Rehabilitation Physician
5101011977
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2984537
—
MI
05
—
3477280
—
MI
05
—
4510933
—
MI
05
—
4614885
—
MI
Enumeration date
05/27/2006
Last updated
02/04/2009
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