MEDICARE: MALAVALLI GOPAL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	38054	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073508693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALAVALLI GOPAL MD

Provider Business Mailing Address
First Line	:	9 NORTHEASTERN BLVD STE 400
Second Line	:
City	:	SALEM
State	:	NH
Zip	:	03079-1996
Country	:	US
Telephone Number	:	800-927-0002
Fax Number	:

Provider Business Practice Location Address
First Line	:	1153 CENTRE ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02130-3446
Country	:	US
Telephone Number	:	617-522-6010
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	08/17/2017

Similar Medicare Providers

1801823620 — DR. JASON P BLOCK MD
Practice Location Address:

75 FRANCIS STREET , BRIGHAM INTERNAL MEDICARE ASSOCIATES
BOSTON, MA
02115

Practice Phone: 617-732-6049
Practice Fax: 617-264-5202

1598054926 — DR. ABIGAIL HART WALDMAN MD
Practice Location Address:

1153 CENTRE ST , SUITE 4J
BOSTON, MA
02130-3446

Practice Phone: 617-983-4626
Practice Fax: 617-983-4504

1811995806 — ELEANOR C PITTS MD
Practice Location Address:

1153 CENTRE ST , SUITE 5790
BOSTON, MA
02130-3446

Practice Phone: 617-522-0008
Practice Fax: 617-522-2587

1417955402 — BOSTON PLASTIC SURGERY ASSOCIATES, PC
Practice Location Address:

1153 CENTRE ST , SUITE 5790
BOSTON, MA
02130-3446

Practice Phone: 617-522-0008
Practice Fax: 617-522-2587

1083601785 — PETER M. REVENO M.D.
Practice Location Address:

1153 CENTRE ST , RADIOLOGY, FAULKNER HOSPITAL
BOSTON, MA
02130-3446

Practice Phone: 617-983-7090
Practice Fax: 617-983-7091

1457348856 — JAMES FRANCIS MASTROMATTEO M.D.
Practice Location Address:

1153 CENTRE ST , RADIOLOGY, FAULKNER HOSPITAL
BOSTON, MA
02130-3446

Practice Phone: 617-983-7163
Practice Fax: 617-983-7553

Directions to “ MALAVALLI GOPAL MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.