Kovaleski, Charles Russell

Kovaleski, Charles Russell is an individual health care provider with primary practice located at 1900 Harrison Ave , Panama City FL 32405-4542. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Kovaleski, Charles Russell can be contacted via phone (850) 769-1668.

Contact Information

Primary practice address
1900 Harrison Ave Panama City FL 32405-4542
Phone: (850) 769-1668
Fax: (850) 785-2123
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X ME36420 Florida

Profile Details

NPI number 1811972391
LBN Legal business name Kovaleski, Charles Russell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2005
Last updated Feb 8th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811972391 NPPES
Florida MEDICAID 039443200
Florida Other 99500

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