Individual
BETTAIAH T GOWDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5041 UTICA RIDGE RD, SUITE 100, DAVENPORT, IA 52807-3480
(563) 359-9696
(563) 359-1730
Mailing address
5041 UTICA RIDGE RD, SUITE 100, DAVENPORT, IA 52807-3480
(563) 359-9696
(563) 359-1730
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036096127
IL
174400000X
Specialist
Primary
34119
IA
Other
Enumeration date
10/19/2005
Last updated
10/29/2007
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