Healthcare Provider Details

I. General information

NPI: 1104841436
Provider Name (Legal Business Name): KARN GUPTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 AZIMUTH CT
ROCKY MOUNT NC
27804-3102
US

IV. Provider business mailing address

30 AZIMUTH CT
ROCKY MOUNT NC
27804-3102
US

V. Phone/Fax

Practice location:
  • Phone: 252-220-5470
  • Fax: 252-627-9091
Mailing address:
  • Phone: 252-220-5470
  • Fax: 252-627-9091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number2006-01729
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: