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Individual

DR. GAUTAM K PAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3850 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-3512
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38044
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A601820
CA
Enumeration date
12/30/2005
Last updated
03/09/2021
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