MEDICARE: RAMESH 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	2085R0001X	Radiation Oncology Physician	01055416	IN
2	2085R0001X	Radiation Oncology Physician	MD2007-0122	NM

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	:	1306831862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAMESH GOPAL MD

Provider Business Mailing Address
First Line	:	800 BRADBURY DR SE STE 116
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-4310
Country	:	US
Telephone Number	:	505-272-1476
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 CAMINO DE SALUD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-4517
Country	:	US
Telephone Number	:	505-272-4946
Fax Number	:

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

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	03/10/2025

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