Provider Demographics
NPI:1811417835
Name:GOMADAM, ARVIND MURALIMOHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ARVIND
Middle Name:MURALIMOHAN
Last Name:GOMADAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:336-765-5553
Mailing Address - Fax:336-765-5359
Practice Address - Street 1:1492 RYMCO DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103
Practice Address - Country:US
Practice Address - Phone:336-765-5553
Practice Address - Fax:336-765-5359
Is Sole Proprietor?:No
Enumeration Date:2017-06-21
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC1929422084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology