Provider Demographics
NPI:1669610168
Name:GOWDA, LOHITH (MD)
Entity type:Individual
Prefix:DR
First Name:LOHITH
Middle Name:
Last Name:GOWDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:LOHITH
Other - Middle Name:
Other - Last Name:SHAKALADEVANAPURA BACHEGOWDA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:37 COLLEGE STREET
Mailing Address - Street 2:DIVISION OF HEMATOLOGY YALE CANCER CENTER
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511
Mailing Address - Country:US
Mailing Address - Phone:203-785-2422
Mailing Address - Fax:
Practice Address - Street 1:SMILOW CANCER CENTER, 35 PARK STREET
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510
Practice Address - Country:US
Practice Address - Phone:203-688-4242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT56886207ZB0001X, 207RH0000X, 207RH0000X
NY274359207ZB0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematologyGroup - Multi-Specialty
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion MedicineGroup - Multi-Specialty