Individual
DR. GAUTAM MALIK
Active
Individual
DR. GAUTAM MALIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-128378
IL
207R00000X
Internal Medicine Physician
Primary
ME143824
FL
208M00000X
Hospitalist Physician
036-128378
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IL5686064
MEDICARE PTAN
IL
Enumeration date
05/24/2008
Last updated
10/21/2021
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