Gautam, Amitabh
Gautam, Amitabh is an individual health care provider with primary practice located at 725 Albany St Shapiro 7Th Floor, Suite 7A, Boston MA 02118-2526. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Transplant Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Transplant Surgery is his primary health care specialty. Gautam, Amitabh can be contacted via phone (617) 638-8430.Contact Information
Primary practice address
725 Albany St Shapiro 7Th Floor, Suite 7A
Boston MA 02118-2526
Phone: (617) 638-8430
Fax: (617) 638-8427
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Transplant Surgery | 204F00000X | 233660 | Massachusetts |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 233660 | Massachusetts |
Profile Details
| NPI number | 1750389565 |
|---|---|
| LBN Legal business name | Gautam, Amitabh |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 14th, 2005 |
| Last updated | Jun 13th, 2014 - about 10 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 | 1750389565 | NPPES |
| Massachusetts | MEDICAID | 110003575A | |
| Massachusetts | MEDICAID | 9023429 |
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