Organization
MEDICAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MADHU SIDDAVEERE GOWDA M. D. (SINGLE MEMBER PROVIDER)
(203) 888-9340
Entity
Organization
Contact information
Practice address
22 WESTFIELD AVE, ANSONIA, CT 06401-1158
(203) 888-9340
(203) 888-9649
Mailing address
63 FARM HILL RD, ORANGE, CT 06477-2335
(203) 888-9340
(203) 888-9649
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
034989
CT
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
034989
CT
207RP1001X
Pulmonary Disease Physician
034989
CT
207RS0012X
Sleep Medicine (Internal Medicine) Physician
034989
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001349895
—
CT
01
—
110008027
MEDICARE PROVIDER NUMBER FOR MADHU GOWDA WHO IS A SINGLE MEMBER OF THIS LLC
—
Enumeration date
09/22/2010
Last updated
07/01/2016
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