MICHAEL KOVACICH MD NPI 1558363309

NPI Information

  • NPI: 1558363309
  • Provider Name: MICHAEL KOVACICH, MD
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • Address: 9660 WICKER AVE
    STE 100E
    ST JOHN, IN
    ZIP 46373
  • Phone: (219) 365-1166

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NPI Details

Michael Kovacich, MD is a family medicine in St John, IN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Michael Kovacich, MD NPI is 1558363309. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

9660 WICKER AVE
STE 100E
ST JOHN, IN
ZIP 46373-487
Phone: (219) 365-1166
Fax: (219) 365-8852

The enumeration date for this NPI number is 8/11/2005 and was last updated on 11/28/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine01033371AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1D69803MEDICARE UPIN
2M400033974MEDICARE PININDIANA
3000000375704OTHERINDIANAANTHEM
4142650KMEDICARE PININDIANA
5100212020MEDICAIDINDIANA
6D69803MEDICARE UPININDIANA
7M400073247MEDICARE PININDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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