Provider Demographics
NPI:1396874632
Name:VYAS, GOPAL RAMESH (DO)
Entity type:Individual
Prefix:DR
First Name:GOPAL
Middle Name:RAMESH
Last Name:VYAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:3500 CHAR LIL CT
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-4831
Mailing Address - Country:US
Mailing Address - Phone:443-801-9291
Mailing Address - Fax:
Practice Address - Street 1:55 WADE AVE
Practice Address - Street 2:SPRING GROVE HOSPITAL CENTER
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4663
Practice Address - Country:US
Practice Address - Phone:410-402-6865
Practice Address - Fax:410-402-6880
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2011-05-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDH00657982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry