Individual
GOPAL R MAJMUNDAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11217 MAIN STREET, MARTIN, KY 41649-0828
(606) 285-9000
(606) 285-9484
Mailing address
11217 MAIN STREET, PO BOX 828, MARTIN, KY 41649-0828
(606) 886-1714
(606) 285-9484
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19452
KY
208000000X
Pediatrics Physician
19452
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000827
CHA
KY
01
—
000000068352
BLUCROSS BLUE SHIELD
KY
01
—
1247781
UMWA
KY
01
—
209332
BLACK LUNG
KY
05
—
64194525
—
KY
Enumeration date
06/28/2005
Last updated
10/12/2012
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