Provider Demographics
NPI:1861430795
Name:VEERARAGHAVAN, GOPAL (MD)
Entity type:Individual
Prefix:DR
First Name:GOPAL
Middle Name:
Last Name:VEERARAGHAVAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:4150 BARRETT BLVD
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-8979
Practice Address - Country:US
Practice Address - Phone:717-738-5648
Practice Address - Fax:717-327-4014
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20650207P00000X
MA259078207RG0100X
PAMD469765207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001720584OtherBCBS
WV1806415000Medicaid
WV110226578OtherRAILROAD MEDICARE
WVP00000522OtherRAILROAD MEDICARE
G63882Medicare UPIN
WV1806415000Medicaid
WVVE4058981Medicare PIN
WVVE4058983Medicare PIN