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Individual

UMA GOWRI GUNNALA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
20045 N 19TH AVE BLDG 11, SUITE 165, PHOENIX, AZ 85027-4252
(623) 572-6791
(623) 572-7099
Mailing address
20045 N 19TH AVE BLDG 11, SUITE 165, PHOENIX, AZ 85027-4252
(602) 572-6791
(623) 572-7099

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25443
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
403379
AZ
Enumeration date
10/27/2006
Last updated
03/09/2017
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