Individual
JEFFREY P MCGOVERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
204 W 26TH ST, ERIE, PA 16508-1806
(814) 864-4755
(814) 864-5430
Mailing address
204 W 26TH ST, ERIE, PA 16508-1806
(814) 864-4755
(814) 864-5430
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD047962L
PA
207RP1001X
Pulmonary Disease Physician
Primary
MD047962L
PA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
MD047962L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018935270001
—
PA
Enumeration date
03/01/2006
Last updated
10/01/2020
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