Provider Demographics
NPI:1033158035
Name:MCGOVERN, TERENCE J (MD)
Entity type:Individual
Prefix:
First Name:TERENCE
Middle Name:J
Last Name:MCGOVERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:200 MILL RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:1030 PRESIDENT AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5923
Practice Address - Country:US
Practice Address - Phone:508-973-1780
Practice Address - Fax:508-973-0359
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA150986207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1033158Medicaid
MA110057936AMedicaid
RI1033158Medicaid
RIS400109455Medicare PIN
MAG37491Medicare UPIN
RI39701-5OtherBCBS
MAA21866OtherMEDICARE OLD IDENTIFIER
RI007056483Medicare ID - Type Unspecified
MA3160424Medicaid
MAA2186601Medicare PIN
MA691012OtherHARVARD PILGRIM