Individual
ADITYA R GOUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2082 MESQUITE AVE STE 100A, LAKE HAVASU CITY, AZ 86403-6710
(928) 453-2727
(928) 453-2828
Mailing address
PO BOX 3539, LAKE HAVASU CITY, AZ 86405-3539
(928) 453-2727
(928) 453-2828
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
62285
AZ
207RI0011X
Interventional Cardiology Physician
Primary
62285
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092161
—
AZ
Enumeration date
07/07/2014
Last updated
06/24/2021
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