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General NPI Number Information
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NPI Number | 1396733218
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Entity Type | Individual
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Provider Name | PAMELA GUERRIERE-KOVACH M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 03/10/2023
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Provider Practice Location Address
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Address Line | 5208 MAHONING AVE STE 208
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City | YOUNGSTOWN
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State | OH
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Zip | 44515-1859
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Country | US
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Telephone | 330-799-9270
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Fax | 330-799-2295
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Provider Business Mailing Address
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Address Line | 5208 MAHONING AVE STE 208
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City | YOUNGSTOWN
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State | OH
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Zip | 44515-1859
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Country | US
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Telephone | 330-799-9270
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Fax | 330-799-2295
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 35074029G
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | 20881
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | 0101231016
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | ME84498
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | MD418830
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | 35074029
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License Number State | OH
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