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General NPI Number Information
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NPI Number | 1033347646
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Entity Type | Organization
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Legal Business Name | MUNE GOWDA MD PLLC
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Dates
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Enumeration Date | 06/23/2009
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Last Update Date | 08/26/2009
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Provider Practice Location Address
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Address Line | 26850 PROVIDENCE PKWY SUITE 125
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City | NOVI
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State | MI
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Zip | 48374-1213
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Country | US
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Telephone | 248-305-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 26850 PROVIDENCE PKWY STE 125
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City | NOVI
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State | MI
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Zip | 48374-1253
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Country | US
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Telephone | 248-305-8400
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MUNE GOWDA
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Credential | M.D.
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Telephone | 248-305-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MG037325
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License Number State | MI
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