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NPI Code Detail

MEDICARE: JEFFREY P MCGOVERN M.D.

MEDICARE: JEFFREY P MCGOVERN M.D.
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
1207RC0200XCritical Care Medicine (Internal Medicine) PhysicianMD047962LPA
2207RS0012XSleep Medicine (Internal Medicine) PhysicianMD047962LPA
3207RP1001XPulmonary Disease PhysicianMD047962LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780651554
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY P MCGOVERN M.D.
Provider Business Mailing Address
First Line : 204 W 26TH ST
Second Line :
City : ERIE
State : PA
Zip : 16508-1806
Country : US
Telephone Number : 814-864-4755
Fax Number : 814-864-5430
Provider Business Practice Location Address
First Line : 204 W 26TH ST
Second Line :
City : ERIE
State : PA
Zip : 16508-1806
Country : US
Telephone Number : 814-864-4755
Fax Number : 814-864-5430
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2006
Last Update Date : 10/01/2020

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