Individual
DR. GAUTAM DEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1205 CAPE CT, SUITE A, FAYETTEVILLE, NC 28304-4404
(910) 678-8611
(910) 678-8100
Mailing address
1205 CAPE CT, SUITE A, FAYETTEVILLE, NC 28304-4404
(910) 678-8611
(910) 678-8100
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
9501525
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0134J
BLUE CROSS
NC
05
—
8928412
—
NC
Enumeration date
03/01/2006
Last updated
01/16/2008
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