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NPI Code Detail

MEDICARE: MRS. SOWMYA GOWDA MD

MEDICARE: MRS. SOWMYA GOWDA MD
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
1390200000XStudent in an Organized Health Care Education/Training ProgramLL1572NV
2207R00000XInternal Medicine Physician13284NV
3208M00000XHospitalist Physician7890466-1205UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346365673
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SOWMYA GOWDA MD
Provider Business Mailing Address
First Line : PO BOX 3299
Second Line :
City : CARSON CITY
State : NV
Zip : 89702
Country : US
Telephone Number : 844-207-4039
Fax Number : 775-222-0056
Provider Business Practice Location Address
First Line : 5505 S 900 E STE 240
Second Line :
City : MURRAY
State : UT
Zip : 84117-7210
Country : US
Telephone Number : 801-783-5011
Fax Number : 801-746-3734
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 07/13/2017

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