Individual
GAUTAM PHOOKAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2525 W UNIVERSITY AVE STE 503, MUNCIE, IN 47303-3409
(765) 288-0441
(765) 282-7879
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
01050143A
IN
207T00000X
Neurological Surgery Physician
1050143
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061570015
MEDICARE
IN
05
—
200206470A
—
IN
01
—
M22404245
MEDICARE
IN
Enumeration date
06/17/2006
Last updated
12/16/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us