Provider Demographics
NPI:1033170030
Name:GOVE, RONALD C (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:C
Last Name:GOVE
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 1:222 NEW RD
Mailing Address - Street 2:CENTRAL PARK EAST
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1282
Mailing Address - Country:US
Mailing Address - Phone:609-927-9790
Mailing Address - Fax:609-926-8796
Practice Address - Street 1:222 NEW RD
Practice Address - Street 2:CENTRAL PARK EAST
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1299
Practice Address - Country:US
Practice Address - Phone:609-927-9790
Practice Address - Fax:609-926-8796
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02955100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ451675Medicare ID - Type Unspecified
D06523Medicare UPIN