Healthcare Provider Details

I. General information

NPI: 1568671782
Provider Name (Legal Business Name): HARSH GOVIL MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/27/2021
Certification Date: 07/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1404 FERN CREEK DR SUITE# 300
STATESVILLE NC
28625-2862
US

IV. Provider business mailing address

PO BOX 1845
STATESVILLE NC
28687-1845
US

V. Phone/Fax

Practice location:
  • Phone: 704-978-4025
  • Fax:
Mailing address:
  • Phone: 704-978-4025
  • Fax: 704-873-1962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number35.089725
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number2010-00414
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number2010-00414
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number2010-00414
License Number StateNC
# 5
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number2010-0414
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: