Individual
GAUTAM PANDURANGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6367 E TANQUE VERDE RD, SUITE 200, TUCSON, AZ 85715-3829
(520) 290-5888
(520) 290-5551
Mailing address
6367 E TANQUE VERDE RD, SUITE 200, TUCSON, AZ 85715-3829
(520) 290-5888
(520) 290-5551
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35089457
OH
207R00000X
Internal Medicine Physician
Primary
37183
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
240518
—
AZ
Enumeration date
06/07/2007
Last updated
01/31/2008
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