NPI 1699245365

John Mark Koucheravy, CPED

Practitioner Pedorthist Rockville, MD

Practice location

Address: 1643 Rockville Pike Unit B, Rockville, MD 20852-7601
Phone: (301) 811-3121
Mailing address: 1621 Quail Run, Charlottesville, VA 22911-9054

Registered specialties

Pedorthist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224L00000X

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Registry record

NPI: 1699245365
Entity type: Individual
Sex (as registered): Male
NPI issued: 26 Nov 2018
Record last updated: 26 Nov 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.