MEDICARE: DR. NIDHI GUPTA M.D.

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	2080P0205X	Pediatric Endocrinology Physician	57351	TN

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

General Provider Information

NPI Number	:	1831406917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NIDHI GUPTA M.D.

Provider Business Mailing Address
First Line	:	400 SUGARTREE LN STE 520
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37064-3083
Country	:	US
Telephone Number	:	615-857-5110
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 SUGARTREE LN STE 520
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37064-3083
Country	:	US
Telephone Number	:	615-857-5110
Fax Number	:

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

Provider Enumeration Date	:	09/09/2010
Last Update Date	:	04/09/2022

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