Healthcare Provider Details
I. General information
NPI: 1366456154
Provider Name (Legal Business Name): JAMES DAVID MCGOWAN MS, RD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
US NAVAL HOSPITAL SIGONELLA PSC 836 BOX 461
FPO AE
09636
IT
IV. Provider business mailing address
US NAVAL HOSPITAL SIGONELLA PSC 836 BOX 461
FPO AE
09636
IT
V. Phone/Fax
- Phone: 09556
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: