Individual
DR. GAUTAM K SINGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6568
(313) 876-1305
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6568
(313) 876-1305
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
108179
MO
2080P0202X
Pediatric Cardiology Physician
108179
MO
2080P0202X
Pediatric Cardiology Physician
Primary
4301503589
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245258920
—
MI
05
—
208027409
—
MO
05
—
ENROLLED
—
IL
Enumeration date
07/18/2006
Last updated
03/01/2021
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