Provider Demographics
NPI:1457563694
Name:SAVITHA GOWDA M.D. P.C.
Entity type:Organization
Organization Name:SAVITHA GOWDA M.D. P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAVITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOWDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-769-3113
Mailing Address - Street 1:95 CHAPEL STREET
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062
Mailing Address - Country:US
Mailing Address - Phone:781-769-3113
Mailing Address - Fax:781-769-8729
Practice Address - Street 1:95 CHAPEL STREET
Practice Address - Street 2:SUITE 3A
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062
Practice Address - Country:US
Practice Address - Phone:781-769-3113
Practice Address - Fax:781-769-8729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA154129207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9723200Medicaid
MAM18097OtherBLUE CROSS
MA600451OtherTUFTS
MAM18097OtherBLUE CROSS