Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | MA76603 | NJ |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 25MA07660300 | NJ |
N | 2080N0001X | Neonatal-Perinatal Doctor | C10011111 | DE |
NPI | 1063452555 |
---|---|
Provider Name | Sharada H. Gowda |
First Address | Philadelphia, PA 19107-3323 |
Second Address | Voorhees, NJ 08043-9612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 22/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0067113 | (05) | NJ |
I00471 | (02) |