| Doctor Name: | DR. CHARLES MIKELL BOVA |
| NPI Number: | 1013071885 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 185699 |
| Business Practice Address: | 3336 Pioneer Pkwy Suite 204 West Valley City, UT - 841202000 |
| Business Phone Number: | 8019643249 |
| Business Fax Number: | |
| Mailing Address: | 3065 Oak Rim Ln, PARK CITY |
| State: | UT |
| Postal Code: | 840606804 |
| Phone Number: | 4356558648 |
| Fax Number: | |
| NPI Enumeration Date: | 12/19/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2081P2900X |
| License Number: | 185699 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Physical Medicine & Rehabilitation |
| Taxonomy Specialization: | Pain Medicine |
| Taxonomy Definition: | A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |