MEDICARE: JENNIFER L COVA D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	34-007858	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	H199541	OTHER	OH	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013913979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER L COVA D.O.

Provider Business Mailing Address
First Line	:	896 S MAIN ST
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45458-3439
Country	:	US
Telephone Number	:	937-433-6513
Fax Number	:	937-291-3398

Provider Business Practice Location Address
First Line	:	896 S MAIN ST
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45458-3439
Country	:	US
Telephone Number	:	937-433-6513
Fax Number	:	937-291-3398

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	03/02/2018

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