MEDICARE: ASHOK K GUPTA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	11941	NV
2	2085R0202X	Diagnostic Radiology Physician	200100541	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01168983	OTHER	NV	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447249495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHOK K GUPTA MD

Provider Business Mailing Address
First Line	:	PO BOX 63112
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28263-3112
Country	:	US
Telephone Number	:	336-274-9617
Fax Number	:	336-482-2177

Provider Business Practice Location Address
First Line	:	1331 N ELM ST STE 200
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27401-6304
Country	:	US
Telephone Number	:	336-274-9617
Fax Number	:	336-482-2177

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	10/14/2024

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Directions to “ ASHOK K GUPTA MD” Practice Location

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