Individual
DR. GAUTAM DAULAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3416 N BUFFALO DR, LAS VEGAS, NV 89129-7424
(702) 565-4917
(702) 562-8680
Mailing address
39 DRIFTING SHADOW WAY, LAS VEGAS, NV 89135-7879
(702) 565-4917
(702) 562-8680
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO 799
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295709418
—
NV
01
—
P00883737
RAILROAD MEDICARE
NV
Enumeration date
02/14/2006
Last updated
04/05/2017
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