Individual provider · Type 1 NPI

Prabesh Gautam, MD

Student in an Organized Health Care Education/Training Program · Cleveland, OH

NPI number 1366115685 Active

Practice location

11100 Euclid Ave
Cleveland, OH 44106-1716

Call (917) 365-9820 Map

Mailing address

33589 Hanover Woods Trl
Solon, OH 44139-4476

Specialties and licenses

TaxonomyCodeLicense
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X35.152286 (OH)
Student in an Organized Health Care Education/Training Program Primary 390200000X57.251164 (OH)

Student in an Organized Health Care Education/Training Program: 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.

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About NPI 1366115685

Prabesh Gautam, MD's National Provider Identifier is 1366115685, issued on Aug 1, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Cleveland, OH. The record was last updated on Mar 29, 2026.