Organization
GERALD G. GOVIN, MD,SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD G. GOVIN M.D. (MEDICAL DOCTOR /OWNER)
(262) 786-3222
Entity
Organization
Contact information
Practice address
16535 W BLUEMOUND RD, SUITE 222, BROOKFIELD, WI 53005-5936
(262) 786-3222
Mailing address
16535 W BLUEMOUND RD, SUITE 222, BROOKFIELD, WI 53005-5936
(262) 786-3222
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
21950
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30529700
—
WI
Enumeration date
09/05/2007
Last updated
09/05/2007
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