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Individual
GAUTAM GHANSHYAMBHAI PATEL
Active
Individual
GAUTAM GHANSHYAMBHAI PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2010-01202
NC
207Q00000X
Family Medicine Physician
R1569
KY
208M00000X
Hospitalist Physician
Primary
2010-01202
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679764054
—
NC
01
—
NC0630D
MEDICARE PIN, INDIV UNDER CHG-WILKES
NC
Enumeration date
08/09/2007
Last updated
06/14/2023
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