Provider Demographics
NPI:1043507908
Name:GULATI, KARTIKE (DO)
Entity Type:Individual
Prefix:
First Name:KARTIKE
Middle Name:
Last Name:GULATI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 MAIN ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-3514
Mailing Address - Country:US
Mailing Address - Phone:219-836-9368
Mailing Address - Fax:219-836-9357
Practice Address - Street 1:2211 MAIN ST STE 1A
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-3514
Practice Address - Country:US
Practice Address - Phone:219-836-9368
Practice Address - Fax:219-836-9357
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN60218207YX0905X
IN02005425A207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Multi-Specialty