Individual
DR. RISHI GAUTAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2401 W BELVEDERE AVE, BALTIMORE, MD 21215-5216
(410) 601-5610
(410) 601-9873
Mailing address
2401 W BELVEDERE AVE, BALTIMORE, MD 21215-5216
(410) 601-5610
(410) 601-9873
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
D83345
MD
2084P0800X
Psychiatry Physician
Primary
D83345
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/22/2012
Last updated
03/08/2022
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