Mallampati, Gautham K
Mallampati, Gautham K is an individual health care provider with primary practice located at 95 Highland Ave Suite 130, Bethlehem PA 18017-9424. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Mallampati, Gautham K can be contacted via phone (610) 868-1100.Contact Information
Primary practice address
95 Highland Ave Suite 130
Bethlehem PA 18017-9424
Phone: (610) 868-1100
Fax: (610) 868-1111
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 056193 | Georgia |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD421847 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 241788 | New York |
Profile Details
| NPI number | 1639159577 |
|---|---|
| LBN Legal business name | Mallampati, Gautham K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 18th, 2006 |
| Last updated | Dec 11th, 2015 - about 11 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 | 1639159577 | NPPES |
| Georgia | MEDICAID | 655000446 |
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