Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | D0065902 | MD |
NPI | 1578770004 |
---|---|
Provider Name | Carlo E Gopez |
First Address | Elkton, MD 21921-5562 |
Second Address | Elkton, MD 21921-5562 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 09/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00415424 | MEDICARE RAILROAD (01) | MD |