Gautam, Umang

Gautam, Umang is an individual health care provider with primary practice located at 2845 Greenbrier Rd , Green Bay WI 54311-6519. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Gautam, Umang can be contacted via phone (920) 288-8000.

Contact Information

Primary practice address
2845 Greenbrier Rd Green Bay WI 54311-6519
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 44330 Wisconsin

Profile Details

NPI number 1477564292
LBN Legal business name Gautam, Umang
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2006
Last updated Nov 16th, 2023 - about 2 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 1477564292 NPPES
Wisconsin MEDICAID 34205800

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