| Doctor Name: | SIMON GEORGE KOVALIK |
| NPI Number: | 1427140037 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 4301039466 |
| Business Practice Address: | 113 Comanche Rd Fort Meade, SD - 577411002 |
| Business Phone Number: | 6057207000 |
| Business Fax Number: | |
| Mailing Address: | 113 Comanche Rd, FORT MEADE |
| State: | SD |
| Postal Code: | 577411002 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/29/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0129X |
| License Number: | 4301039466 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Vascular Surgery |
| Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |