Organization
MAIN STREET FAMILY MEDICINE ,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHANDRE C GOWDA M.D. (PHYSICIAN)
(614) 253-8537
Entity
Organization
Contact information
Practice address
1336 E MAIN ST, COLUMBUS, OH 43205-2081
(614) 253-8537
(614) 253-8539
Mailing address
881 E MAIN ST, COLUMBUS, OH 43205-1713
(614) 253-8537
(614) 253-8539
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35085235
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2606415
—
OH
Enumeration date
12/26/2006
Last updated
05/14/2015
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