Individual
MOHAN GAUTAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18001 ROTUNDA DR, DEARBORN, MI 48124-3984
(313) 633-2300
Mailing address
26901 BEAUMONT BLVD # 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1952
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
5101026584
MI
Other
Enumeration date
04/07/2018
Last updated
01/27/2023
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