Individual
SANDEEP GAUTAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
427 US 31W BYP, BOWLING GREEN, KY 42101-1703
(270) 796-8800
(270) 796-9328
Mailing address
427 US 31W BYP, BOWLING GREEN, KY 42101-1703
(270) 796-8800
(270) 796-9328
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
45253
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100209510
—
KY
Enumeration date
05/20/2006
Last updated
09/14/2022
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