MEDICARE: DR. DREW A. KOVACH MD

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	207Q00000X	Family Medicine Physician	MD-8012	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000001131	OTHER	HI	HMSA BILLING NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366537615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DREW A. KOVACH MD

Provider Business Mailing Address
First Line	:	415 SOUTH ST
Second Line	:	SUITE 3404
City	:	HONOLULU
State	:	HI
Zip	:	96813-5052
Country	:	US
Telephone Number	:	808-531-5815
Fax Number	:	888-981-1554

Provider Business Practice Location Address
First Line	:	415 SOUTH ST
Second Line	:	SUITE 3404
City	:	HONOLULU
State	:	HI
Zip	:	96813-5052
Country	:	US
Telephone Number	:	808-531-5815
Fax Number	:	888-981-1554

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	02/06/2015

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