Provider Demographics
NPI:1275108938
Name:GAUTAM, GARIMA (MD)
Entity type:Individual
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First Name:GARIMA
Middle Name:
Last Name:GAUTAM
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1290 SILAS DEANE HIGHWAY
Mailing Address - Street 2:CREDENTIALING VERIFICATION ORGANIZATION, HARTFORD HEALT
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109
Mailing Address - Country:US
Mailing Address - Phone:202-449-0827
Mailing Address - Fax:860-972-7040
Practice Address - Street 1:100 GRAND STREET
Practice Address - Street 2:HOSPITAL OF CENTRAL CONNECICUT
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052
Practice Address - Country:US
Practice Address - Phone:959-595-1751
Practice Address - Fax:860-266-5785
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2024-06-28
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Provider Licenses
StateLicense IDTaxonomies
CT76442207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine