| V G Gautam Md Pc | |
|
393 Ocean Ave New London CT 06320-4717 | |
| (860) 442-5976 | |
| Not Available |
| Full Name | V G Gautam Md Pc |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 393 Ocean Ave, New London, Connecticut |
| Authorized Official Name and Position | Vibha G Gautam (OWNER) |
| Authorized Official Contact | 8604425976 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| V G Gautam Md Pc 393 Ocean Ave New London CT 06320-4717 Ph: (860) 442-5976 | V G Gautam Md Pc 393 Ocean Ave New London CT 06320-4717 Ph: (860) 442-5976 |
| NPI Number | 1609075639 |
|---|---|
| Provider Enumeration Date | 07/11/2007 |
| Last Update Date | 07/11/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609075639 | NPI | - | NPPES |
| 001218486 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 021848 (Connecticut) | Primary |
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