Individual
DR. SHOVENDRA GAUTAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 GRAND ST, NEW BRITAIN, CT 06052-2016
(860) 224-5011
Mailing address
24 HOSPITAL AVE, APT 102, DANBURY, CT 06810-6099
(484) 478-1213
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
48882
CT
208M00000X
Hospitalist Physician
Primary
48882
CT
Other
Enumeration date
07/06/2010
Last updated
07/06/2010
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