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General NPI Number Information
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NPI Number | 1750373445
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Entity Type | Individual
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Provider Name | EUGENE A. DONOVAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 10/15/2011
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Provider Practice Location Address
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Address Line | 412 NAMOZINE STREET
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City | BURKEVILLE
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State | VA
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Zip | 23922
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Country | US
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Telephone | 434-767-4822
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Fax | 434-767-2211
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Provider Business Mailing Address
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Address Line | PO BOX 927 5 E ALVON ROAD, SUITE 7
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City | WHITE SULPHUR SPRINGS
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State | WV
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Zip | 24986-2373
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Country | US
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Telephone | 304-536-5030
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Fax | 304-536-5051
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101032228
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License Number State | VA
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