Provider Demographics
NPI:1275514473
Name:GOVIL, YOGESH K (MD)
Entity Type:Individual
Prefix:
First Name:YOGESH
Middle Name:K
Last Name:GOVIL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:101 E OLNEY AVE
Mailing Address - Street 2:SUITE 505
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-2421
Mailing Address - Country:US
Mailing Address - Phone:215-456-7000
Mailing Address - Fax:215-254-2599
Practice Address - Street 1:5401 OLD YORK RD
Practice Address - Street 2:KLEIN BLDG, SUITE 202
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-3030
Practice Address - Country:US
Practice Address - Phone:215-456-8210
Practice Address - Fax:215-329-1085
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2015-02-23
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Provider Licenses
StateLicense IDTaxonomies
PAMD063810L207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0792186101Medicaid
PA0792186101Medicaid
PA035715Medicare PIN