Individual
SHASHIKUMAR R GOWDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1429 N 6TH ST, TERRE HAUTE, IN 47807-1037
(812) 242-3109
(812) 242-3990
Mailing address
221 S 6TH ST, TERRE HAUTE, IN 47807-4214
(812) 242-3109
(812) 242-3990
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
01045040A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
36091244
IL
207RP1001X
Pulmonary Disease Physician
01045040A
IN
207RP1001X
Pulmonary Disease Physician
36091244
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000226195
ANTHEM
—
05
—
200111360
—
IN
05
—
200111360O
—
IN
05
—
200111360S
—
IN
05
—
200111360X
—
IN
01
—
P00834961
RAILROAD MEDICARE
IN
01
—
P01053285
RAILROAD MEDICARE
IL
Enumeration date
08/25/2006
Last updated
03/14/2013
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