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General NPI Number Information
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NPI Number | 1609862630
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Entity Type | Individual
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Provider Name | GOPALA DWARAKANATH M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/26/2005
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Last Update Date | 10/23/2015
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Provider Practice Location Address
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Address Line | 2 HOSPITAL DR
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City | LOWELL
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State | MA
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Zip | 01852-1311
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Country | US
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Telephone | 978-618-5550
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Fax | 978-937-6842
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Provider Business Mailing Address
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Address Line | 290 BROADWAY 104
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City | METHUEN
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State | MA
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Zip | 01844-6827
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Country | US
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Telephone | 978-683-5115
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Fax | 978-683-7337
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 50393
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 9652
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 50393
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 9652
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License Number State | NH
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