Provider Demographics
NPI:1770539264
Name:RUGHANI, GOVIND NAIN (MD)
Entity type:Individual
Prefix:
First Name:GOVIND
Middle Name:NAIN
Last Name:RUGHANI
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 1:401 GUESS ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4155
Mailing Address - Country:US
Mailing Address - Phone:864-233-2744
Mailing Address - Fax:864-233-7359
Practice Address - Street 1:56 SAINT MARK RD
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-5233
Practice Address - Country:US
Practice Address - Phone:864-235-1066
Practice Address - Fax:864-235-1073
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC15943207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
571107258003OtherBLUE CHOICE SC
SC159438Medicaid
571107258002OtherBCBS SC
571107258003OtherBLUE CHOICE SC
SC159438Medicaid