Provider Demographics
NPI:1972965820
Name:GOWDA, ARVIND UMESH (MD)
Entity Type:Individual
Prefix:DR
First Name:ARVIND
Middle Name:UMESH
Last Name:GOWDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2801 E CAMELBACK RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4363
Mailing Address - Country:US
Mailing Address - Phone:480-576-4310
Mailing Address - Fax:480-576-4311
Practice Address - Street 1:2801 E CAMELBACK RD STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4363
Practice Address - Country:US
Practice Address - Phone:480-576-4310
Practice Address - Fax:480-576-4311
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301505697208200000X
390200000X
AZ70948208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program