Provider Demographics
NPI:1871756791
Name:NANAVATI, AMAR GAUTAM (MD)
Entity type:Individual
Prefix:DR
First Name:AMAR
Middle Name:GAUTAM
Last Name:NANAVATI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1360 WEST ONTARIO STREET
Mailing Address - Street 2:JONES HALL 9TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140
Mailing Address - Country:US
Mailing Address - Phone:609-320-7856
Mailing Address - Fax:
Practice Address - Street 1:1360 WEST ONTARIO STREET
Practice Address - Street 2:JONES HALL 9TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140
Practice Address - Country:US
Practice Address - Phone:609-320-7856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA09165900208M00000X
PAMD443502207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine