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NPI Code Detail

MEDICARE: SHIVANI GUPTA

MEDICARE: SHIVANI GUPTA
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
1390200000XStudent in an Organized Health Care Education/Training ProgramDC
2207R00000XInternal Medicine Physician83799CT

General Provider Information

NPI Number : 1740977719
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIVANI GUPTA
Provider Business Mailing Address
First Line : 110 IRVING ST NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20010-3017
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 110 IRVING ST NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20010-3017
Country : US
Telephone Number : 202-877-8278
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2023
Last Update Date : 03/12/2026

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Directions to “ SHIVANI GUPTA ” Practice Location

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