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General NPI Number Information
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NPI Number | 1679800494
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Entity Type | Individual
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Provider Name | ALISA KOVAL MD
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Gender | Female
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Dates
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Enumeration Date | 11/16/2009
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Last Update Date | 11/07/2012
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Provider Practice Location Address
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Address Line | 1400 JACKSON ST.
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City | DENVER
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State | CO
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Zip | 80206
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Country | US
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Telephone | 303-398-1528
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Fax | 303-270-2174
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Provider Business Mailing Address
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Address Line | 1400 JACKSON ST
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City | DENVER
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State | CO
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Zip | 80206-2761
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Country | US
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Telephone | 303-388-4461
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Fax | 303-270-2174
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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 | 2083P0500X
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Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
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License Number | 0051620
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License Number State | CO
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