Healthcare Provider Details

I. General information

NPI: 1891811691
Provider Name (Legal Business Name): MEERA RAMONA GOPAUL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF KANSAS MEDICAL CTR 3901 RAINBOW BLVD MS 4010
KANSAS CITY KS
66160-0001
US

IV. Provider business mailing address

2408 W PAWNEE ST APT 241
WICHITA KS
67213-2882
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-1902
  • Fax: 913-588-1951
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number94-06475
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: