Individual
GOPALAN SRIDHAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 RAYMOND ST, READING, PA 19605-3149
(610) 921-1111
(610) 921-2419
Mailing address
555 RAYMOND ST, READING, PA 19605-3149
(610) 921-1111
(610) 921-2419
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD423219
PA
208000000X
Pediatrics Physician
Primary
MD423219
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100888848
—
PA
Enumeration date
11/02/2005
Last updated
12/17/2019
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