Individual
DR. GOUTHAM SHANKARGOUD PATIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
44405 WOODWARD AVE # H-23, PONTIAC, MI 48341-5023
(646) 633-3789
Mailing address
44405 WOODWARD AVE # H-23, PONTIAC, MI 48341-5023
(646) 633-3789
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4351048155
MI
207R00000X
Internal Medicine Physician
5315225359
MI
Other
Enumeration date
06/28/2021
Last updated
07/02/2021
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