Provider Demographics
NPI:1013272780
Name:GOPIE, SEMIRA VASANTI (MBBS)
Entity Type:Individual
Prefix:DR
First Name:SEMIRA
Middle Name:VASANTI
Last Name:GOPIE
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3031 W GRAND BLVD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3046
Mailing Address - Country:US
Mailing Address - Phone:313-916-3761
Mailing Address - Fax:313-916-8343
Practice Address - Street 1:3031 W GRAND BLVD
Practice Address - Street 2:SUITE 800
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3046
Practice Address - Country:US
Practice Address - Phone:313-916-3761
Practice Address - Fax:313-916-8343
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP27646207R00000X
MI4301108121282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine