Provider Demographics
NPI:1558691634
Name:GOVAN, PREEYA (MD)
Entity Type:Individual
Prefix:
First Name:PREEYA
Middle Name:
Last Name:GOVAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 E THOMAS RD
Mailing Address - Street 2:BUILDING C, 1ST FLOOR
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-7710
Mailing Address - Country:US
Mailing Address - Phone:602-933-2923
Mailing Address - Fax:602-933-0806
Practice Address - Street 1:1919 E THOMAS RD
Practice Address - Street 2:BUILDING C, 1ST FLOOR
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7710
Practice Address - Country:US
Practice Address - Phone:602-933-2923
Practice Address - Fax:602-933-0806
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR71378208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics