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NPI Code Detail

MEDICARE: DR. JANICE N COVERDALE M.D.

MEDICARE: DR. JANICE N COVERDALE M.D.
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
1208000000XPediatrics Physician26218NC

Other Identifiers

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

General Provider Information

NPI Number : 1982670055
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JANICE N COVERDALE M.D.
Provider Business Mailing Address
First Line : PO BOX 69
Second Line :
City : MARSHALL
State : NC
Zip : 28753-0069
Country : US
Telephone Number : 828-649-9566
Fax Number : 828-649-3786
Provider Business Practice Location Address
First Line : 590 MEDICAL PARK DR
Second Line :
City : MARSHALL
State : NC
Zip : 28753-6807
Country : US
Telephone Number : 828-649-3500
Fax Number : 828-649-1032
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2006
Last Update Date : 02/04/2015

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