Individual
RAM GAUTAM GORANTLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 E MCDOWELL RD, PHOENIX, AZ 85006-2612
(602) 839-2000
Mailing address
7710 MERCY RD STE 202, OMAHA, NE 68124-2353
(402) 280-4392
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
64275
AZ
207R00000X
Internal Medicine Physician
7984
NE
Other
Enumeration date
08/14/2017
Last updated
09/14/2021
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