Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 57.030527 | OH |
Y | 207T00000X | Neurosurgeon | 63984 | MN |
NPI | 1003135013 |
---|---|
Provider Name | Dr. Robert Allen Mcgovern III |
First Address | Cleveland Heights, OH 44121-1516 |
Second Address | Minneapolis, MN 55455 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2010 |
Last Update Date | 22/06/2018 |