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Individual

RAMAYYA U GOWDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
180 SOUTH MAIN STREET, CANTON, IL 61520-2608
(309) 647-0201
(309) 649-6880
Mailing address
180 SOUTH MAIN STREET, CANTON, IL 61520-2608
(309) 647-0201
(309) 649-5101

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036-053154
IL
208600000X
Surgery Physician
036053154
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0062839
UMWA
IL
01
014148
HEALTH ALLIANCE
IL
01
02922981
BCBS
IL
05
036053154
IL
01
053154
OSF HEALTHPLANS
IL
01
136064
HEALTH LINK
IL
01
1942315197
NPI CLINIC NUMBER
IL
01
200397
BLACK LUNG
IL
01
770002357
RR MEDICARE PIN
IL
01
CG5172
RR MEDICARE GROUP#
IL
01
IL0108
JOHN DEERE
IL
Enumeration date
08/28/2006
Last updated
04/15/2016
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