Individual
BHASKAR GOWDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 PROGRESS PKWY, SULLIVAN, MO 63080-2359
(888) 403-1071
Mailing address
15992 TROWBRIDGE RD, CHESTERFIELD, MO 63017-7339
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2002031642
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209022417
—
MO
Enumeration date
12/20/2005
Last updated
12/12/2023
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