Individual
PARAKKAT GOPALAKRISHNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
119 W LOWMAN ST, MULLINS, SC 29574-3107
(843) 464-4000
(843) 464-4017
Mailing address
119 W LOWMAN ST, MULLINS, SC 29574-3107
(843) 464-4000
(843) 464-4017
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
7929
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079293
—
SC
05
—
GP0379
—
SC
01
—
GP5462
MEDICAID GROUP
SC
Enumeration date
06/25/2006
Last updated
06/07/2012
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