Healthcare Provider Details

I. General information

NPI: 1801311956
Provider Name (Legal Business Name): SHASHIKALA BASAV GOWDA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHASHIKALA BASAV GOWDA MD

II. Dates (important events)

Enumeration Date: 08/10/2017
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-3661
  • Fax: 316-844-8900
Mailing address:
  • Phone: 216-844-1171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number35.154220
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: