MEDICARE: RONALD C. GOVE, MD, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1417919176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONALD C. GOVE, MD, PA

Provider Business Mailing Address
First Line	:	222 NEW RD
Second Line	:	CENTRAL PARK EAST
City	:	LINWOOD
State	:	NJ
Zip	:	08221-1282
Country	:	US
Telephone Number	:	609-927-9790
Fax Number	:	609-926-8796

Provider Business Practice Location Address
First Line	:	222 NEW RD
Second Line	:	CENTRAL PARK EAST
City	:	LINWOOD
State	:	NJ
Zip	:	08221-1299
Country	:	US
Telephone Number	:	609-927-9790
Fax Number	:	609-926-8796

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	CHRISTINE K. MATHIS
Credential	:
Telephone Number	:	609-927-9790

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	12/03/2009

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