Provider Demographics
NPI:1528244936
Name:MASALIA, GOPI (MD)
Entity type:Individual
Prefix:
First Name:GOPI
Middle Name:
Last Name:MASALIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3833 FAIRFAX DR
Mailing Address - Street 2:# 200
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1772
Mailing Address - Country:US
Mailing Address - Phone:703-525-8863
Mailing Address - Fax:
Practice Address - Street 1:3833 FAIRFAX DR
Practice Address - Street 2:# 200
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1772
Practice Address - Country:US
Practice Address - Phone:703-525-8863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA0885160207R00000X
390200000X
VA0101248239207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program