MEDICARE: GABOR BODONYI-KOVACS 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	207RN0300X	Nephrology Physician	MD044757	DC
2	207RN0300X	Nephrology Physician	60924	MT

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	:	1821288051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABOR BODONYI-KOVACS MD

Provider Business Mailing Address
First Line	:	75 CLAREMONT ST STE H
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-3500
Country	:	US
Telephone Number	:	406-752-7406
Fax Number	:	406-752-7544

Provider Business Practice Location Address
First Line	:	75 CLAREMONT ST STE H
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-3500
Country	:	US
Telephone Number	:	406-752-7406
Fax Number	:	406-752-7544

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

Provider Enumeration Date	:	07/25/2007
Last Update Date	:	11/27/2023

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