Provider Demographics
NPI:1588224190
Name:GOVRO, EMILY JUNE (DO, MS)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:JUNE
Last Name:GOVRO
Suffix:
Gender:F
Credentials:DO, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5194 JEREMIAH BLVD
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:MO
Mailing Address - Zip Code:63050-5815
Mailing Address - Country:US
Mailing Address - Phone:636-543-2328
Mailing Address - Fax:636-543-2329
Practice Address - Street 1:5194 JEREMIAH BLVD
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:MO
Practice Address - Zip Code:63050-5815
Practice Address - Country:US
Practice Address - Phone:636-543-2328
Practice Address - Fax:636-543-2329
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-17
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022026436207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty