Provider Demographics
NPI:1427170554
Name:KALE, GAUTAM (MD)
Entity type:Individual
Prefix:DR
First Name:GAUTAM
Middle Name:
Last Name:KALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N ELAM AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1118
Mailing Address - Country:US
Mailing Address - Phone:651-402-0260
Mailing Address - Fax:
Practice Address - Street 1:501 N ELAM AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1118
Practice Address - Country:US
Practice Address - Phone:651-402-0260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-01544207R00000X, 207RA0401X, 207RH0000X, 207RH0003X, 207RH0005X, 207RX0202X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0005XAllopathic & Osteopathic PhysiciansInternal MedicineHypertension Specialist
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology