Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD453273 | PA |
Y | 2080P0208X | Pediatric Infectious Diseases | MD453273 | PA |
NPI | 1023397197 |
---|---|
Provider Name | Dr. Swathi Mannava Gowtham |
First Address | Danville, PA 17822-4903 |
Second Address | Danville, PA 17822-1320 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2011 |
Last Update Date | 26/08/2020 |