Provider Demographics
NPI:1306289251
Name:MCGOVERN, JOHN MICHAEL (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:MICHAEL
Last Name:MCGOVERN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7545 BEECHMONT AVE
Mailing Address - Street 2:SUITE K
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-4222
Mailing Address - Country:US
Mailing Address - Phone:513-564-4277
Mailing Address - Fax:513-564-4278
Practice Address - Street 1:7545 BEECHMONT AVE
Practice Address - Street 2:SUITE K
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-4222
Practice Address - Country:US
Practice Address - Phone:513-564-4277
Practice Address - Fax:513-564-4278
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.012258207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine