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General NPI Number Information
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NPI Number | 1336128222
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Entity Type | Individual
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Provider Name | MARK W KOVACH M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 12/24/2025
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Provider Practice Location Address
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Address Line | 201 BJC SAINT PETERS DR STE 200
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City | SAINT PETERS
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State | MO
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Zip | 63376-3386
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Country | US
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Telephone | 636-916-9615
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Fax | 636-916-9850
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Provider Business Mailing Address
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Address Line | PO BOX 959354
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City | SAINT LOUIS
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State | MO
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Zip | 63195-9354
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Country | US
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Telephone | 636-916-9615
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Fax | 636-916-9850
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 036098054
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | V4257
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 159182
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License Number State | MT
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Taxonomy #4
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 2025044853
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License Number State | MO
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