Provider Demographics
NPI:1851433965
Name:KARAKAT S & INDIRA V GOKULANATHAN PTR
Entity Type:Organization
Organization Name:KARAKAT S & INDIRA V GOKULANATHAN PTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARAKAT
Authorized Official - Middle Name:SANKARAN
Authorized Official - Last Name:GOKULANATHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-262-7432
Mailing Address - Street 1:9470 ANNAPOLIS RD STE 311
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3022
Mailing Address - Country:US
Mailing Address - Phone:301-262-7432
Mailing Address - Fax:
Practice Address - Street 1:9470 ANNAPOLIS RD STE 311
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3022
Practice Address - Country:US
Practice Address - Phone:301-262-7432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MH00043152080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty