Individual
DIPIKA JAIRAM GOPAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3400 SPRUCE STREET, 100 CENTREX, PHILADELPHIA, PA 19104
(215) 662-2200
Mailing address
3400 SPRUCE STREET, 100 CENTREX, PHILADELPHIA, PA 19104
(215) 662-2200
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
MT205758
PA
Other
Enumeration date
04/24/2014
Last updated
02/11/2022
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