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Individual
PUSHPA GOPAL
Active
Individual
PUSHPA GOPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
152035
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2095611
—
MA
01
—
466502
TUFTS HEALTH PLAN
MA
01
—
AA53435
HARVARD PILGRIM
MA
01
—
J27586
BLUE CROSS BLUE SHIELD
MA
Enumeration date
06/09/2005
Last updated
11/20/2007
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