Provider Demographics
NPI:1417919176
Name:RONALD C. GOVE, MD, PA
Entity Type:Organization
Organization Name:RONALD C. GOVE, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:K
Authorized Official - Last Name:MATHIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-927-9790
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ046916Medicare ID - Type Unspecified