Individual
GAUTHAM GONDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
146 E HOSPITAL DR STE 350, WEST COLUMBIA, SC 29169-4800
(803) 314-9640
(803) 314-9641
Mailing address
2405 ATHERHOLT RD, LYNCHBURG, VA 24501-2184
(434) 485-8500
(434) 485-8599
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101055531
VA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
90617
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010160910
—
VA
05
—
1952336034
—
VA
01
—
P00220180
MEDICARE RAILROAD PIN
VA
Enumeration date
07/11/2006
Last updated
03/18/2026
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