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Individual

CAMERON M GOVONLU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1244 BROADWAY, RAYNHAM, MA 02767-1973
(508) 824-0035
(508) 823-6127
Mailing address
1244 BROADWAY, RAYNHAM, MA 02767-1973
(508) 824-0035
(508) 823-6127

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
47135
MA
208VP0014X
Interventional Pain Medicine Physician
Primary
47135
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0176753
MA
Enumeration date
07/23/2006
Last updated
01/16/2013
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