MEDICARE: RICHARD A. COVERT M.D., MPH

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	2083X0100X	Occupational Medicine Physician	E-4518	AR

General Provider Information

NPI Number	:	1689631194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD A. COVERT M.D., MPH

Provider Business Mailing Address
First Line	:	1 VILLAGE SQ
Second Line	:	SUITE A
City	:	HAZELWOOD
State	:	MO
Zip	:	63042-1817
Country	:	US
Telephone Number	:	314-731-9675
Fax Number	:	314-731-2522

Provider Business Practice Location Address
First Line	:	1 VILLAGE SQ
Second Line	:	SUITE A
City	:	HAZELWOOD
State	:	MO
Zip	:	63042-1817
Country	:	US
Telephone Number	:	314-731-9675
Fax Number	:	314-731-2522

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	09/06/2007

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