Individual
GOWTHAM GANNAMANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
727 SE MAIN ST STE 340, SIMPSONVILLE, SC 29681-3249
(864) 455-2888
(864) 455-2885
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
86254
SC
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
LL86254
SC
Other
Enumeration date
04/09/2018
Last updated
06/06/2023
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