Provider Demographics
NPI:1558760124
Name:KOWSIKA, SRIVATSA CHIHNA (PA-C)
Entity type:Individual
Prefix:MR
First Name:SRIVATSA
Middle Name:CHIHNA
Last Name:KOWSIKA
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:15059 N SCOTTSDALE RD STE 600
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-2685
Mailing Address - Country:US
Mailing Address - Phone:602-778-3601
Mailing Address - Fax:928-432-7001
Practice Address - Street 1:4755 OGLETOWN STANTON RD STE 5A43
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-2200
Practice Address - Country:US
Practice Address - Phone:302-623-0188
Practice Address - Fax:302-733-5640
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2025-01-13
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Provider Licenses
StateLicense IDTaxonomies
MI5601007070363A00000X
MDC0009591363A00000X
DEC5-0001060363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant