Individual
SAMIR GAUTAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
950 CAMPBELL AVE # 11ACSL1, VA CONNECTICUT HEALTHCARE SYSTEM, WEST HAVEN, CT 06516-2770
(203) 688-8300
Mailing address
20 YORK ST, YALE-NEW HAVEN HOSPITAL, NEW HAVEN, CT 06510-3220
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/27/2015
Last updated
05/27/2015
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