Doctor Name: | DR. DAVID WILLIAM MCGOVERN |
NPI Number: | 1124021670 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.M. |
License Number: | 0560000083 |
Business Practice Address: | 150 Kennedy Dr South Burlington, VT - 054036749 |
Business Phone Number: | 8028593668 |
Business Fax Number: | 8028593669 |
Mailing Address: | 150 Kennedy Dr, SOUTH BURLINGTON |
State: | VT |
Postal Code: | 054036749 |
Phone Number: | 8028593668 |
Fax Number: | 8028593669 |
NPI Enumeration Date: | 05/28/2005 |
NPI Last Update Date: | 05/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213EP1101X |
License Number: | 0560000083 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Primary Podiatric Medicine |
Taxonomy Definition: |