Provider Demographics
NPI:1801800768
Name:KOVARSKY, JOEL S (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:S
Last Name:KOVARSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1839 CLAY DR
Mailing Address - Street 2:
Mailing Address - City:CROZET
Mailing Address - State:VA
Mailing Address - Zip Code:22932-2880
Mailing Address - Country:US
Mailing Address - Phone:434-823-5696
Mailing Address - Fax:
Practice Address - Street 1:1839 CLAY DR
Practice Address - Street 2:
Practice Address - City:CROZET
Practice Address - State:VA
Practice Address - Zip Code:22932-2880
Practice Address - Country:US
Practice Address - Phone:434-823-5696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053727207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6055893Medicaid
VA6055893Medicaid