Individual
DR. GAUTAM GULATI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1308 SUNNY SIDE LN, MC LEAN, VA 22102-1526
(202) 345-1228
Mailing address
PO BOX 10423, MC LEAN, VA 22102-8423
(202) 345-1228
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01001001619
MD
Other
Enumeration date
05/16/2011
Last updated
05/16/2011
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