Provider Demographics
NPI:1770749822
Name:GOWDIE, DONOVAN AUDLEY (DPM)
Entity type:Individual
Prefix:DR
First Name:DONOVAN
Middle Name:AUDLEY
Last Name:GOWDIE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2504 W ALBERSON DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31721-2024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1412 W OAKRIDGE DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-5307
Practice Address - Country:US
Practice Address - Phone:229-435-2424
Practice Address - Fax:229-435-2324
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006288213ES0103X
GAPOD001117213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery