Organization
ERIE SHORE WOMENS HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORIE L KOVACH MD (OWNER)
(440) 934-8344
Entity
Organization
Contact information
Practice address
5054 WATERFORD PLACE DR, ELYRIA, OH 44035
(440) 934-8344
Mailing address
524 CLEVELAND ST, ELYRIA, OH 44035-4055
(440) 934-8344
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000387553
ANTHEM BLUE CROSS
OH
05
—
2637721
—
OH
01
—
DF0746
PALMETTO GBA RETIRED
OH
Enumeration date
09/13/2007
Last updated
12/06/2011
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