Individual provider · NPI-1

Dr. Meera Gopu, MD

Otolaryngology, Plastic Surgery within the Head & Neck · Peoria, IL

NPI number1609442912
StatusActive
Last updated in NPPESNov 25, 2024

Details

NPI
1609442912
Entity type
Individual (NPI-1)
Name
Dr. Meera Gopu
Credential
MD
Sex
Female
Sole proprietor
No
Enumeration date
May 28, 2021
Certification date
Nov 22, 2024
Last updated
Nov 25, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck288601MAYes

Practice location

8600 Illinois Rt 91
Ste. 300
Peoria, IL 61615

Phone 309-691-6616 · Fax 309-282-3848

Mailing address

8600 Illinois Rt 91
Ste 300
Peoria, IL 61615

Other practice locations

736 Cambridge St
Brighton, MA 02135-2907

Phone 617-789-3000

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