Individual
GAUTAM MUKUND PHADKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1640 CAMPUS PARK DR STE C, MONROE, NC 28112-5284
(704) 226-0366
(704) 226-9535
Mailing address
3158 FREEDOM DR STE 3102, CHARLOTTE, NC 28208-0014
(704) 971-7099
(704) 971-0035
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
11322
ND
207RN0300X
Nephrology Physician
2009006929
MO
207RN0300X
Nephrology Physician
Primary
2019-01383
NC
390200000X
Student in an Organized Health Care Education/Training Program
RL10218
ND
Other
Enumeration date
10/17/2008
Last updated
04/02/2025
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