Individual
DR. BIKKI GAUTAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 384-5416
(704) 384-5992
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-5416
(704) 384-5992
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2016-01246
NC
207R00000X
Internal Medicine Physician
4301100201
MI
207R00000X
Internal Medicine Physician
MD52392
TN
208M00000X
Hospitalist Physician
Primary
2016-01246
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619107356
—
MI
Enumeration date
07/15/2009
Last updated
10/26/2020
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