Individual
DR. GAUTAM R. VELAMOOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6198
(206) 223-8824
Mailing address
1100 9TH AVE, MS M4-PFS, SEATTLE, WA 98101-2756
(206) 583-6025
(206) 515-5886
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD00044502
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3460VE
BLUE SHIELD #
WA
05
—
8493793
—
WA
01
—
8890836
MEDICARE PTAN - KITSAP CO
WA
01
—
P00707717
RAILROAD MC PIN
WA
01
—
US9094075
AETNA PCP PIN
WA
Enumeration date
06/29/2007
Last updated
06/11/2010
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