Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 150986 | MA |
Y | 207RP1001X | Pulmonary Disease | 150986 | MA |
NPI | 1033158035 |
---|---|
Provider Name | Terence J Mcgovern |
First Address | Fairhaven, MA 02719-5252 |
Second Address | Fall River, MA 02720-5923 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 23/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1033158 | (05) | RI |
110057936A | (05) | MA |