| Goudar Corporation | |
|
110 Kingsley Ln Suite 209 Norfolk VA 23505-4614 | |
| (757) 489-3911 | |
| (757) 889-3913 |
| Full Name | Goudar Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 110 Kingsley Ln, Norfolk, Virginia |
| Authorized Official Name and Position | Mohan Hire Goudar (PRESIDENT) |
| Authorized Official Contact | 7574893911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Goudar Corporation 110 Kingsley Ln Suite 209 Norfolk VA 23505-4614 Ph: (757) 489-3911 | Goudar Corporation 110 Kingsley Ln Suite 209 Norfolk VA 23505-4614 Ph: (757) 489-3911 |
| NPI Number | 1861593717 |
|---|---|
| Provider Enumeration Date | 09/25/2006 |
| Last Update Date | 11/20/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861593717 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101030509 (Virginia) | Primary |
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