Provider Demographics
NPI:1134215072
Name:KAMAT, GAYATRI (MD)
Entity type:Individual
Prefix:
First Name:GAYATRI
Middle Name:
Last Name:KAMAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 S HOUSTON LAKE RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-9093
Mailing Address - Country:US
Mailing Address - Phone:478-333-6977
Mailing Address - Fax:478-333-6973
Practice Address - Street 1:623 S HOUSTON LAKE RD
Practice Address - Street 2:SUITE 500
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-9093
Practice Address - Country:US
Practice Address - Phone:478-333-6977
Practice Address - Fax:478-333-6973
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA049458207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA241787219AMedicaid
GA11BDWXKMedicare PIN
GA241787219AMedicaid