Healthcare Provider Details

I. General information

NPI: 1184620205
Provider Name (Legal Business Name): JAMES J MCGOVERN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 01/31/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 VANDERBILT PARK DR
ASHEVILLE NC
28803-1700
US

IV. Provider business mailing address

PO BOX 602381
CHARLOTTE NC
28260-2381
US

V. Phone/Fax

Practice location:
  • Phone: 828-274-6000
  • Fax: 828-225-4637
Mailing address:
  • Phone: 828-274-6000
  • Fax: 828-225-4637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number9701053
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number9701053
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: