Dmitri Kovalev, MD | |
2 Innovation Dr Ste 350, Greenville, SC 29607-5269 | |
(864) 516-1170 | |
(877) 249-9483 |
Full Name | Dmitri Kovalev |
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Gender | Male |
Speciality | Psychiatry & Neurology - Neurology |
Location | 2 Innovation Dr Ste 350, Greenville, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1730675117 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | 89512 (South Carolina) | Primary |
2084N0400X | Psychiatry & Neurology - Neurology | BP10063903 (Texas) | Secondary |
Entity Name | Bon Secours Medical Group Greenville Specialty Care Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1821679580 PECOS PAC ID: 1850779976 Enrollment ID: O20220602000070 |
Mailing Address | Practice Location Address |
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Dmitri Kovalev, MD Po Box 631341, Cincinnati, OH 45263-1341 Ph: () - | Dmitri Kovalev, MD 2 Innovation Dr Ste 350, Greenville, SC 29607-5269 Ph: (864) 516-1170 |
Kathleen Valeska Woschkolup, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 801 Roper Creek Dr, Greenville, SC 29615 Phone: 864-516-1170 Fax: 877-249-9483 | |
Benjamin Todd Griffeth, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 701 Grove Rd, Ste 200, Greenville, SC 29605 Phone: 864-455-8431 | |
Meng Zhou-wang, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 200 Patewood Dr, Suite B350, Greenville, SC 29615 Phone: 864-454-4500 Fax: 864-454-4505 | |
Dr. Marc Taro Ishizuka, D.O. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 41 Park Creek Dr, Va Outpatient Clinic In Greenville, Greenville, SC 29605 Phone: 864-299-1600 | |
Karen Sue Stacher, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 124 Mallard Street, Greenville, SC 29601 Phone: 864-241-1040 Fax: 864-241-1049 | |
Dr. Ambreen A Ahmad, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 27 Memorial Medical Dr, Greenville, SC 29605 Phone: 864-295-2221 Fax: 864-220-6109 | |
Mr. Thomas C Perry Jr., MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 200 Patewood Dr Ste B350, Greenville, SC 29615 Phone: 864-454-4500 Fax: 864-454-4505 |