Individual
MR. GAUTAM DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1010 CARONDELET DR, SUITE #220, KANSAS CITY, MO 64114-4859
(816) 941-1600
(816) 941-1699
Mailing address
6675 HOLMES RD, KANSAS CITY, MO 64131-1150
(816) 276-7600
(816) 276-7992
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO 119578
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
245068309
—
MO
Enumeration date
06/05/2006
Last updated
08/29/2016
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