Individual
DR. GOUTHAM KOLLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1400 W 22ND ST, SIOUX FALLS, SD 57105-1554
(605) 357-1300
Mailing address
3008 W CINNAMON ST, SIOUX FALLS, SD 57108-6233
(605) 496-8343
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9442
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720366818
—
SD
Enumeration date
07/24/2011
Last updated
02/15/2018
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