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NPI Code Detail

MEDICARE: GOWRI GOUDA

MEDICARE: GOWRI GOUDA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician5101029031MI
22084P0800XPsychiatry Physician99010GA

General Provider Information

NPI Number : 1174146674
Entity Type Code : Individual
Provider Name (Legal Business Name) : GOWRI GOUDA
Provider Business Mailing Address
First Line : 102 KINLOCH DR
Second Line :
City : PERRYSBURG
State : OH
Zip : 43551-1339
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 502 E CUMMINS ST
Second Line :
City : TECUMSEH
State : MI
Zip : 49286-2074
Country : US
Telephone Number : 517-423-3887
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2020
Last Update Date : 01/30/2026

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Directions to “ GOWRI GOUDA ” Practice Location

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