Healthcare Provider Details

I. General information

NPI: 1770539264
Provider Name (Legal Business Name): GOVIND NAIN RUGHANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 05/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 SAINT MARK RD
TAYLORS SC
29687-5233
US

IV. Provider business mailing address

401 GUESS ST SUITE 100
GREENVILLE SC
29605-4155
US

V. Phone/Fax

Practice location:
  • Phone: 864-235-1066
  • Fax: 864-235-1073
Mailing address:
  • Phone: 864-233-2744
  • Fax: 864-233-7359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number15943
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: