Individual
GAUTAM BASKARAN
Active
Individual
GAUTAM BASKARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
2011014212
MO
207RP1001X
Pulmonary Disease Physician
Primary
Q0003
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
335691703
—
TX
01
—
P02599916
MCRR
TX
Enumeration date
06/05/2008
Last updated
06/17/2024
Update your record
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