Provider Demographics
NPI:1003815473
Name:GOLOVAN, RONALD (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:GOLOVAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 FRANKLIN BLVD
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-2993
Mailing Address - Country:US
Mailing Address - Phone:216-696-2205
Mailing Address - Fax:216-363-2058
Practice Address - Street 1:2709 FRANKLIN BLVD
Practice Address - Street 2:SUITE 2E
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-2993
Practice Address - Country:US
Practice Address - Phone:216-696-2205
Practice Address - Fax:216-363-2058
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-060871-G207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0858611Medicaid
OH54563OtherQUALCHOICE
OHF60871OtherSUMMACARE
OH341939294-00OtherWORKERS COMP
OH000000187185OtherANTHEM BC/BS
OH341939294027OtherCARESOURCE
OH0402830OtherUNITED HEALTHCARE
OH54563OtherQUALCHOICE
OH4036131Medicare PIN