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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245352574 NPPES
Arizona MEDICAID 520072

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