Healthcare Provider Details

I. General information

NPI: 1235114075
Provider Name (Legal Business Name): PIUSH GUPTA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6949 GOOD SAMARITAN DR
CINCINNATI OH
45247-5204
US

IV. Provider business mailing address

6949 GOOD SAMARITAN DR
CINCINNATI OH
45247-5204
US

V. Phone/Fax

Practice location:
  • Phone: 513-853-9250
  • Fax: 513-281-1908
Mailing address:
  • Phone: 513-853-9250
  • Fax: 513-281-1908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35.082168
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: