Doctor Name: | DR. MICHELE MCGOWAN |
NPI Number: | 1053330589 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.P.M. |
License Number: | PO2977 |
Business Practice Address: | 3150 Citrus Tower Blvd Suite B Clermont, FL - 347116802 |
Business Phone Number: | 3522422502 |
Business Fax Number: | 3522420316 |
Mailing Address: | 3150 Citrus Tower Blvd, Suite B CLERMONT |
State: | FL |
Postal Code: | 347116802 |
Phone Number: | 3522422502 |
Fax Number: | 3522420316 |
NPI Enumeration Date: | 07/18/2006 |
NPI Last Update Date: | 11/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | PO2977 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |