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Individual

DR. IVAN DARIUS GOWAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
85 COLLEGE ST, HAMILTON, NY 13346-1227
(315) 824-1250
Mailing address
85 COLLEGE ST, HAMILTON, NY 13346-1227
(315) 824-1250

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
153105
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00842957
NY
Enumeration date
03/17/2006
Last updated
09/14/2007
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