Provider Demographics
NPI:1871194118
Name:GOPINATHAN, VINEET (PHARMD)
Entity Type:Individual
Prefix:
First Name:VINEET
Middle Name:
Last Name:GOPINATHAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 WOODS RD APT 115
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-3162
Mailing Address - Country:US
Mailing Address - Phone:919-720-1007
Mailing Address - Fax:
Practice Address - Street 1:3634 REYNOLDA RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-2230
Practice Address - Country:US
Practice Address - Phone:336-923-2367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29652183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist