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NPI Code Detail

MEDICARE: NICHOLAS JOVANOVICH

MEDICARE: NICHOLAS JOVANOVICH
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
1207R00000XInternal Medicine PhysicianOS016665PA

General Provider Information

NPI Number : 1679884290
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS JOVANOVICH
Provider Business Mailing Address
First Line : 651 COLLIERS WAY STE 300
Second Line :
City : WEIRTON
State : WV
Zip : 26062-5058
Country : US
Telephone Number : 304-797-6535
Fax Number :
Provider Business Practice Location Address
First Line : 560 STEUBENVILLE PIKE
Second Line :
City : BURGETTSTOWN
State : PA
Zip : 15021-8539
Country : US
Telephone Number : 724-947-5350
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2010
Last Update Date : 05/03/2023

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Directions to “ NICHOLAS JOVANOVICH ” Practice Location

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