Individual
DR. GOWDA SHARATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
405 RUSHING DR, HERRIN, IL 62948-3730
(618) 993-3300
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
(618) 993-0262
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036121565
IL
208M00000X
Hospitalist Physician
036121565
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036121565
—
IL
Enumeration date
08/15/2008
Last updated
06/14/2024
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