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DR. GAUTAM RANGAVAJLA MD
NPI 1407485766
Student in an Organized Health Care Education/Training Program in Detroit, MI

Active since April 07, 2020
2799 W GRAND BLVD, DETROIT, MI 48202(313) 916-2600 Get Directions Write a Review

NPPES record last updated: June 15, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Jun 15, 2023, Apr 7, 2020 (2 updates tracked since 2020).

About Dr. Gautam Rangavajla Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GAUTAM RANGAVAJLA MD (NPI 1407485766) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since April 2020.

NPPES Registry Identity

NPI1407485766
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. GAUTAM RANGAVAJLACredential: MD
Location Address2799 W GRAND BLVDDetroit, MI 48202-2689
Mailing Address3600 Forbes Ave Ste 140Pittsburgh, PA 15213-3410
Phone(313) 916-2600
Sole ProprietorNo
Enumeration DateApril 7, 2020
Last NPPES UpdateJune 15, 20232 updates tracked since enumeration
NPPES CertifiedJune 15, 2023
✔ NPI 1407485766 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2799 W GRAND BLVD, Detroit, MI 48202
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HENRY FORD HOSPITAL
General Acute Care Hospital
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
DR. BRENT DAVID GRIFFITH M.D.
Radiology (Diagnostic Radiology)
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
KANIKA KHANNA M.D
Radiology (Diagnostic Radiology)
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
DR. FADL A CHOKR M.D.
Family Medicine
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
AVI COHEN M.D.
Internal Medicine (Pulmonary Disease)
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
LINDSEY AURORA
Internal Medicine (Cardiovascular Disease)
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
KYLE KRUPA
Nurse Anesthetist, Certified Registered
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
ALEXANDER GARBARINO
Internal Medicine (Pulmonary Disease)
2799 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gautam Rangavajla's NPI number?

The NPI number for Gautam Rangavajla is 1407485766. It was assigned to this individual provider in the NPPES registry on April 7, 2020.

Where is Gautam Rangavajla located?

Gautam Rangavajla practices at 2799 W Grand Blvd, Detroit, MI 48202. The listed phone number is (313) 916-2600.

What is Gautam Rangavajla's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Gautam Rangavajla was last updated on June 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.