Individual
GOWD SHIVA NAGARAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 343-7074
Mailing address
PO BOX 20169, ROANOKE, VA 24018-0506
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
2009-00324
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
152K9
BCBS OF NC
NC
05
—
5911282
—
NC
Enumeration date
03/21/2007
Last updated
10/16/2018
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