Healthcare Provider Details

I. General information

NPI: 1265621171
Provider Name (Legal Business Name): RONALD GOLOVAN, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2007
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 W 25TH ST STE 2E
CLEVELAND OH
44113-3108
US

IV. Provider business mailing address

1730 W 25TH ST STE 2E
CLEVELAND OH
44113-3108
US

V. Phone/Fax

Practice location:
  • Phone: 216-696-2205
  • Fax: 216-363-2058
Mailing address:
  • Phone: 216-696-2205
  • Fax: 216-363-2058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35060871
License Number StateOH

VIII. Authorized Official

Name: DR. RONALD GOLOVAN
Title or Position: OWNER
Credential: M.D.
Phone: 216-696-2205