Basic Information
Provider Information
NPI: 1710034533
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BHAVE
FirstName: GAUTAM
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3841 GREEN HILLS VILLAGE DR STE 200
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372152691
CountryCode: US
TelephoneNumber: 6153223000
FaxNumber:  
Practice Location
Address1: 3601 THE VANDERBILT CLINIC
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372320001
CountryCode: US
TelephoneNumber: 6153223000
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/04/2007
LastUpdateDate: 03/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RN0300XMD0000043837TNY Allopathic & Osteopathic PhysiciansInternal MedicineNephrology

No ID Information.


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