Provider Demographics
NPI:1063500064
Name:ATIYA H GOPALANI MD PA
Entity Type:Organization
Organization Name:ATIYA H GOPALANI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ATIYA
Authorized Official - Middle Name:H
Authorized Official - Last Name:GOPALANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-570-4866
Mailing Address - Street 1:18111 PRINCE PHILIP DR
Mailing Address - Street 2:STE 126
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832
Mailing Address - Country:US
Mailing Address - Phone:301-570-4866
Mailing Address - Fax:301-570-0236
Practice Address - Street 1:18111 PRINCE PHILIP DR
Practice Address - Street 2:STE 126
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832
Practice Address - Country:US
Practice Address - Phone:301-570-4866
Practice Address - Fax:301-570-0236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD36981207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty