Mcgovern, Thomas William

Mcgovern, Thomas William is an individual health care provider with primary practice located at 7881 Carnegie Blvd , Fort Wayne IN 46804-5792. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Procedural Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Mcgovern, Thomas William can be contacted via phone (260) 436-8000.

Contact Information

Primary practice address
7881 Carnegie Blvd Fort Wayne IN 46804-5792
Phone: (260) 436-8000
Fax: (260) 432-5587
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 01052178A Indiana
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X 01052178A Indiana
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 01052178A Indiana

Profile Details

NPI number 1982702742
LBN Legal business name Mcgovern, Thomas William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Mar 7th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982702742 NPPES
Indiana Other 01052178B CSR LICENSE NUMBER
Indiana MEDICAID 200254690 CSR LICENSE NUMBER
Indiana Other 2576 CSR LICENSE NUMBER
Indiana Other 5878557 CSR LICENSE NUMBER
Indiana Other P00060564 CSR LICENSE NUMBER
Indiana Other 000000308075 CSR LICENSE NUMBER

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