Provider Demographics
NPI:1285881912
Name:GOPAL K NAIR, MD, PC
Entity type:Organization
Organization Name:GOPAL K NAIR, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GOPAL
Authorized Official - Middle Name:K
Authorized Official - Last Name:NAIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-434-0640
Mailing Address - Street 1:1023 ARLINGTON OAKS TER
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-5936
Mailing Address - Country:US
Mailing Address - Phone:314-434-0640
Mailing Address - Fax:636-566-8732
Practice Address - Street 1:1023 ARLINGTON OAKS TER
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-5936
Practice Address - Country:US
Practice Address - Phone:314-434-0640
Practice Address - Fax:636-566-8732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-25
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8341207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200951630Medicaid
MO200951630Medicaid
MODN8885Medicare PIN
MO000094279Medicare PIN