Organization
GUNDUMALLA S GOUD MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUNDUMALLA S GOUD MD (PRESIDENT)
(440) 350-7444
Entity
Organization
Contact information
Practice address
7529 FREDLE DR, CONCORD TWP, OH 44077-9406
(440) 350-7444
(440) 350-7440
Mailing address
7529 FREDLE DR, CONCORD TWP, OH 44077-9406
(440) 350-7444
(440) 350-7440
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35044133
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0468480
—
OH
01
—
110001483A
RR MEDICARE
OH
Enumeration date
05/09/2008
Last updated
06/09/2008
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