Individual
GAUTHAM K MALLAMPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
95 HIGHLAND AVE, SUITE 130, BETHLEHEM, PA 18017-9424
(610) 868-1100
(610) 868-1111
Mailing address
95 HIGHLAND AVE, SUITE 130, BETHLEHEM, PA 18017-9424
(610) 868-1100
(610) 868-1111
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
056193
GA
2085R0202X
Diagnostic Radiology Physician
241788
NY
2085R0202X
Diagnostic Radiology Physician
MD421847
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
655000446
—
GA
Enumeration date
01/18/2006
Last updated
12/11/2015
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