Provider Demographics
NPI:1265621171
Name:RONALD GOLOVAN, M.D., INC.
Entity type:Organization
Organization Name:RONALD GOLOVAN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-696-2205
Mailing Address - Street 1:1730 W 25TH ST STE 2E
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-3108
Mailing Address - Country:US
Mailing Address - Phone:216-696-2205
Mailing Address - Fax:216-363-2058
Practice Address - Street 1:1730 W 25TH ST STE 2E
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-3108
Practice Address - Country:US
Practice Address - Phone:216-696-2205
Practice Address - Fax:216-363-2058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35060871207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0858611Medicaid
F60871OtherSUMMACARE
OH000000187185OtherANTHEM
0402830OtherUNITED HEALTHCARE
110213818OtherRAILROAD MEDICARE
OH351284OtherWELLCARE OF OHIO
OH302482804007OtherMEDICAL MUTUAL OF OHIO
=========027OtherCARESOURCE
=========027OtherCARESOURCE
OHF38279Medicare UPIN