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NPI Code Detail

MEDICARE: GAUTAM PRATAP YAGNIK MD

MEDICARE:   GAUTAM PRATAP YAGNIK  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianMD427446PA
2207XX0005XSports Medicine (Orthopaedic Surgery) PhysicianME101360FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609936475
Entity Type Code : Individual
Provider Name (Legal Business Name) : GAUTAM PRATAP YAGNIK MD
Provider Business Mailing Address
First Line : PO BOX 100905
Second Line :
City : ATLANTA
State : GA
Zip : 30384-0905
Country : US
Telephone Number : 786-467-3430
Fax Number : 786-533-9695
Provider Business Practice Location Address
First Line : 15955 SW 96TH ST STE 401
Second Line :
City : MIAMI
State : FL
Zip : 33196-1273
Country : US
Telephone Number : 786-467-3430
Fax Number : 786-533-9695
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 01/30/2022

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Directions to “ GAUTAM PRATAP YAGNIK MD” Practice Location

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