Individual
JAY J GOPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 E UNIVERSITY PKWY, 33RD STREET BUILDING SUITE 233, BALTIMORE, MD 21218-2829
(410) 554-2696
(410) 554-2570
Mailing address
10395 KINGSBRIDGE RD, ELLICOTT CITY, MD 21042-5851
(410) 554-2919
(410) 554-2570
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D31052
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
75859903
BLUE SHIELD
MD
Enumeration date
03/04/2006
Last updated
03/03/2008
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