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General NPI Number Information
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NPI Number | 1780633610
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Entity Type | Individual
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Provider Name | TIMOTHY C GOVAERTS M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 3563 PRAIRIEVIEW ST
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City | GRAND ISLAND
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State | NE
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Zip | 68803-4419
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Country | US
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Telephone | 308-382-2010
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 860876
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City | MINNEAPOLIS
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State | MN
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Zip | 55486-0876
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Country | US
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Telephone | 402-483-8590
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Fax |
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | DR.0052036
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 12924A
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License Number State | WY
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Taxonomy #3
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 19063
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License Number State | NE
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