DR. KEMPAIAH A GOWDA (NPI# 1730133265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730133265 |
| Entity Type | Individual |
| Full Name | DR. KEMPAIAH A GOWDA |
| Credential | MD |
| Practice Address |
15150 Fort St Southgate MI 48195-1302 |
| Practice Telephone | 7342824800 |
| Practice Fax Number | 7342829302 |
| Mailing Telephone | 7342824800 |
| Mailing Fax Number | 7342829302 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2017-03-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
4301037652 | MI | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
4301037654 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CARE NETWORK | 0820105 | 01 |
| MI | HAP | B43075 | 01 |
| MI | BLUE CROSS BLUE SHIELD | 0608201051 | 01 |
| MI | 1623343 | 05 | |
| MI | RR MEDICARE | 110007760 | 01 |
| MI | BCBS TYPE 1 NPI # | 1730133265 | 01 |
| MI | STATE LICENSE # | 4301037652 | 01 |
| MI | CDS # | 4301037652 | 01 |
| MI | CAQH | 11277306 | 01 |
| Street Address |
15150 FORT ST |
| City | SOUTHGATE |
| State | MI |
| Zip Code | 48195-1302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699777995 | Mustafa A Hashem | Internal Medicine | 15150 Fort St, Southgate, MI 48195-1302 | 2005-06-01 |
| 1629693791 | Diana Bischer | Nurse Practitioner | 15150 Fort St, Southgate, MI 48195-1302 | 2020-06-14 |
| 1104390350 | Daniel Fenderson | Nurse Practitioner | 15150 Fort St, Southgate, MI 48195-1302 | 2019-01-21 |
| 1871957985 | Natisha Irene Clark | Registered Nurse | 15150 Fort St, Southgate, MI 48195-1302 | 2016-04-06 |
| 1871958744 | Saba Madhoun | Physician Assistant | 15150 Fort St, Southgate, MI 48195-1302 | 2015-12-21 |
| 1437415874 | Mashkur Husain | Internal Medicine | 15150 Fort St, Southgate, MI 48195-1302 | 2012-04-10 |
| 1396976080 | Ashraf Ehab Mostafa | Internal Medicine | 15150 Fort St, Southgate, MI 48195 | 2009-07-29 |
| 1225294168 | Qaiser Shafiq | Internal Medicine | 15150 Fort St, Southgate, MI 48195 | 2008-07-30 |
| 1568620003 | Nitin K. Gupta | Internal Medicine | 15150 Fort St, Southgate, MI 48195-1302 | 2008-05-31 |
| 1578767950 | Ameen A Abdulmalik | Internal Medicine | 15150 Fort St, Southgate, MI 48195-1302 | 2007-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780206656 | Destiny D Harris | Social Worker | 14799, Southgate, MI 48195 | 2020-05-13 |
| 1285102368 | Svs Vision Inc | Eyewear Supplier (Equipment, not the service) | 16256 Fort St, Southgate, MI 48195 | 2018-11-07 |
| 1003382979 | Saran Charisse Watts | Case Manager/Care Coordinator | 31101 Allen Rd, Building 5, Southgate, MI 48195 | 2018-10-18 |
| 1255824025 | Kiesta Janell Lindsey | Social Worker | 13101 Allen Rd Bldg 4-f, Southgate, MI 48195 | 2018-06-07 |
| 1417473224 | Suzette Michele Watson | Nurse Practitioner | 14319 Dix-toledo, Southgate, MI 48195 | 2017-08-15 |
| 1275069486 | Liza Du Plessis | Student in an Organized Health Care Education/Training Program | 13111 Allen Road, Southgate, MI 48195 | 2017-05-08 |
| 1497290456 | Beaumont Health | Clinic/Center | 15777 Northline, Southgate, MI 48195 | 2016-12-30 |
| 1184172876 | Felicia Wilson | Licensed Practical Nurse | 15771 Wildemere, Southgate, MI 48195 | 2016-09-12 |
| 1225487978 | Stacey Petrick-strickland | Technician, Other | 12189 Agnes, Southgate, MI 48195 | 2016-06-03 |
| 1205298486 | Ashley Francis | Hearing Instrument Specialist | 18800 Eureka Rd., Southgate, MICHIGAN 48195 | 2016-03-25 |
| Find all providers in zip 48195 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396976080 | Ashraf Ehab Mostafa | Internal Medicine | 15150 Fort St, Southgate, MI 48195 | 2009-07-29 |
| 1568620003 | Nitin K. Gupta | Internal Medicine | 15150 Fort St, Southgate, MI 48195-1302 | 2008-05-31 |
| 1578767950 | Ameen A Abdulmalik | Internal Medicine | 15150 Fort St, Southgate, MI 48195-1302 | 2007-06-12 |
| 1194838383 | Downriver Heart and Vascular Specialists PC | Internal Medicine | 15150 Fort St, Southgate, MI 48195-1302 | 2006-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154458 | Spectrum Health Primary Care Partners | Internal Medicine | 749 Phillips St, South Haven, MI 49090-1842 | 2020-11-05 |
| 1902413891 | Atria Vascular & Vein, Pllc | Internal Medicine | 32255 Northwestern Hwy Ste 115a, Farmington Hills, MI 48334-1566 | 2020-09-25 |
| 1538785415 | Lakes Cardiology PC | Internal Medicine | 9640 Commerce Rd Ste 106, Commerce Twp, MI 48382-4167 | 2020-06-17 |
| 1811468895 | Telemedico Physicians of Michigan | Internal Medicine | 24359 Northwestern Hwy Ste 200, Southfield, MI 48075-2597 | 2018-12-17 |
| 1639644305 | Metropolitan Cardiovascular | Internal Medicine | 28667 Bayberry Ct E, Livonia, MI 48154-3869 | 2018-10-09 |
| 1194202234 | Mvp Endovascular Center Pllc | Internal Medicine | 22720 Michigan Ave Ste 300, Dearborn, MI 48124-2035 | 2018-07-22 |
| 1366992059 | Renew Research LLC | Internal Medicine | 26800 Haggerty Rd, Farmington Hills, MI 48331-5715 | 2016-10-06 |
| 1972051530 | Michael Abdul-malek Do Pllc | Internal Medicine | 1380 Coolidge Hwy Ste 250, Troy, MI 48084-7067 | 2016-09-13 |
| 1205389384 | Elite Medical Enterprises, Inc. | Internal Medicine | 7750 Schaefer Rd Ste 202, Dearborn, MI 48126-1159 | 2016-07-26 |
| 1265803316 | Alpine Cardiology, Pllc | Internal Medicine | 101 E Mitchell St, Gaylord, MI 49735-1460 | 2015-10-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.