Individual
DR. GAUTAM S CHOURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
612 W BASELINE RD, MESA, AZ 85210-6041
(480) 834-9039
(480) 964-7802
Mailing address
612 W BASELINE RD, MESA, AZ 85210-6041
(480) 834-9039
(480) 964-7802
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
43064
AZ
207RN0300X
Nephrology Physician
A112711
CA
207RN0300X
Nephrology Physician
MT192264
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
520072
—
AZ
Enumeration date
04/06/2007
Last updated
05/25/2012
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