Choure, Gautam S
Choure, Gautam S is an sole proprietor health care provider with primary practice located at 612 W Baseline Rd , Mesa AZ 85210-6041. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Choure, Gautam S can be contacted via phone (480) 834-9039.Contact Information
Primary practice address
612 W Baseline Rd
Mesa AZ 85210-6041
Phone: (480) 834-9039
Fax: (480) 964-7802
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | MT192264 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 43064 | Arizona |
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | A112711 | California |
Profile Details
| NPI number | 1245352574 |
|---|---|
| LBN Legal business name | Choure, Gautam S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 6th, 2007 |
| Last updated | May 25th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245352574 | NPPES |
| Arizona | MEDICAID | 520072 |
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