Individual
DR. NITHIN GOTTAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
7633 E JEFFERSON AVE, STE 360, DETROIT, MI 48214-3730
(313) 499-4769
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125055096
IL
207RC0000X
Cardiovascular Disease Physician
4301097629
MI
207RI0011X
Interventional Cardiology Physician
Primary
4301097629
MI
Other
Enumeration date
07/09/2008
Last updated
06/19/2015
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