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General NPI Number Information
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NPI Number | 1801915350
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Entity Type | Individual
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Provider Name | RUDY KOVACHEVICH M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 11/13/2014
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Provider Practice Location Address
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Address Line | 601 E HAMPDEN AVE SUITE 500
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City | ENGLEWOOD
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State | CO
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Zip | 80113-3781
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Country | US
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Telephone | 303-744-7078
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Fax | 303-744-0248
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Provider Business Mailing Address
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Address Line | 601 E HAMPDEN AVE SUITE 500
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City | ENGLEWOOD
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State | CO
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Zip | 80113-3781
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Country | US
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Telephone | 303-744-7078
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Fax | 303-744-0248
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 49777
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 01069735A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | DR51415
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License Number State | CO
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