Individual
GODA P DAMERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3128 WHEATON WAY, APT E, ELLICOTT CITY, MD 21043
(775) 997-5066
Mailing address
6019 WALNUT GROVE RD, MEMPHIS, TN 38120-2113
(775) 997-5066
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
52104
TN
Other
Enumeration date
09/21/2010
Last updated
11/06/2018
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