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Individual

DR. JEFFREY RICHARD KOVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
4660 S HAGADORN RD STE 420, EAST LANSING, MI 48823-5353
(517) 884-6100
(517) 884-6233
Mailing address
4660 S HAGADORN RD, SUITE 420, EAST LANSING, MI 48823-5353
(517) 884-6100

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5101010030
MI
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
5101010030
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1902819162
MI
05
3194525
MI
Enumeration date
08/15/2006
Last updated
04/13/2011
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