Provider Demographics
NPI:1376656306
Name:GOPINATH, RAMYA (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMYA
Middle Name:
Last Name:GOPINATH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2377
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21041-2377
Mailing Address - Country:US
Mailing Address - Phone:410-884-1311
Mailing Address - Fax:
Practice Address - Street 1:11055 LITTLE PATUXENT PKWY
Practice Address - Street 2:SUITE 209
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2896
Practice Address - Country:US
Practice Address - Phone:410-884-1311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0059346207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD402077400Medicaid
MDG972OtherBLUECHOICE MARYLAND GRP #
MDKES7INOtherCAREFIRST MARYLAND GRP #
MDDA5812OtherRAILROAD MEDICARE GROUP #
MD602MMedicare PIN
MD402077400Medicaid