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Individual

GURUSHANKAR GOVINDARAJAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
442 W HIGH ST, BRYAN, OH 43506-1681
(419) 636-4517
(419) 636-6438
Mailing address
442 W HIGH ST, BRYAN, OH 43506-1681
(419) 636-4517
(419) 636-6438

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-094289
OH
207R00000X
Internal Medicine Physician
T2005021696
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00800474
RAILROAD
OH
Enumeration date
10/05/2006
Last updated
04/29/2010
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