Individual
GAUTHAMI BALAGOPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1099
(617) 665-1000
Mailing address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1099
(617) 665-1000
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
1023307
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2022
Last updated
05/27/2025
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