Individual
UMANG GAUTAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-8000
Mailing address
PO BOX 735041, CHICAGO, IL 60673-5041
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
44330
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34205800
—
WI
Enumeration date
08/10/2006
Last updated
11/16/2023
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