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Individual

DR. GOURI RAVIN PIMPUTKAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
GP014942
MI
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
OS16869
FL
207VX0000X
Obstetrics Physician
Primary
OS16869
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
114809581
MI
01
BLUE CROSS
1656314165
MI
Enumeration date
08/10/2006
Last updated
08/20/2021
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