Provider Demographics
NPI:1609927276
Name:GOWDA, SAVITHA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAVITHA
Middle Name:
Last Name:GOWDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 CHAPEL ST
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3155
Mailing Address - Country:US
Mailing Address - Phone:781-769-3113
Mailing Address - Fax:781-769-8729
Practice Address - Street 1:95 CHAPEL ST
Practice Address - Street 2:SUITE 3A
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3155
Practice Address - Country:US
Practice Address - Phone:781-769-3113
Practice Address - Fax:781-769-8729
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA154129207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3197212Medicaid
J19919OtherBLUE SHIELD (BS)
154129OtherTUFTS (TA)
68812OtherHARVARD PILGRIM (HP)
J19919OtherBLUE SHIELD (BS)
68812OtherHARVARD PILGRIM (HP)