Organization
PRIMECARE PEDIATRICS
Active
Other names
DR JAY GOPAL MD
Organization subpart
No
Provider details
NPI number
Authorized official
JAY GOPAL (OWNER)
(410) 532-2147
Entity
Organization
Contact information
Practice address
5820 YORK RD, STE 23, BALTIMORE, MD 21212-3610
(410) 532-2147
(410) 323-9376
Mailing address
5820 YORK RD, STE 23, BALTIMORE, MD 21212-3610
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
D31052
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2133154
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/07/2006
Last updated
08/22/2020
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