1184288573 NPI number — DR. HARISH KUMAR GOPALAKRISHNA PILLAI

Table of content: DR. HARISH KUMAR GOPALAKRISHNA PILLAI (NPI 1184288573)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184288573 NPI number — DR. HARISH KUMAR GOPALAKRISHNA PILLAI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOPALAKRISHNA PILLAI
Provider First Name:
HARISH KUMAR
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184288573
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/12/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 CENTER DRIVER BUILDING 10 ROOM 4-5722 SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETHESDA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20892-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
571-317-8312
Provider Business Mailing Address Fax Number:
667-234-3525

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 CENTER DRIVE BUILDING 10
Provider Second Line Business Practice Location Address:
ROOM 4-5722 SW
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20892-5299
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
571-317-8312
Provider Business Practice Location Address Fax Number:
667-234-3525
Provider Enumeration Date:
05/01/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  D0093942 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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