Provider Demographics
NPI:1447208566
Name:GOVIL, AMIT (MD)
Entity Type:Individual
Prefix:
First Name:AMIT
Middle Name:
Last Name:GOVIL
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:PO BOX 636256
Mailing Address - Street 2:CENTRAL CREDENTIALING
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6256
Mailing Address - Country:US
Mailing Address - Phone:513-585-5504
Mailing Address - Fax:513-585-5511
Practice Address - Street 1:231 ALBERT SABIN WAY
Practice Address - Street 2:ML0585
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45267-0585
Practice Address - Country:US
Practice Address - Phone:513-558-0668
Practice Address - Fax:513-558-4309
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-077747207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200830190Medicaid
OH2675298Medicaid
KY64035827Medicaid
OHP00330862OtherRAIL ROAD MEDICARE
H47016Medicare UPIN
IN200830190Medicaid
KY64035827Medicaid