Provider Demographics
NPI:1972793420
Name:GOPASETTY, MAHESH SRISAILAPPA (MBBS, MS, MRCS)
Entity Type:Individual
Prefix:DR
First Name:MAHESH
Middle Name:SRISAILAPPA
Last Name:GOPASETTY
Suffix:
Gender:M
Credentials:MBBS, MS, MRCS
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Mailing Address - Street 1:45 SYCAMORE AVE
Mailing Address - Street 2:APT 523
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-6710
Mailing Address - Country:US
Mailing Address - Phone:843-792-3368
Mailing Address - Fax:
Practice Address - Street 1:96 JONATHAN LUCAS ST
Practice Address - Street 2:CSB 404
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-8900
Practice Address - Country:US
Practice Address - Phone:843-792-3368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCSCLL29704204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery