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Individual

DR. GONCHIGARI NARAYANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4350 7TH STREET A, MOLINE, IL 61265
(566) 355-9191
(563) 355-3419
Mailing address
4350 7TH STREET A, MOLINE, IL 61265
(566) 355-9191
(563) 355-3419

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
036079304
IL
2084P0800X
Psychiatry Physician
Primary
30780
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3136002
IA
01
42884
WELLMARK HEALTH PLAN
IA
01
IA01B1
JOHN DEERE HEALTH PLAN
Enumeration date
10/06/2005
Last updated
02/09/2015
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