Healthcare Provider Details
I. General information
NPI: 1013367374
Provider Name (Legal Business Name): NEEL AKASH GUPTA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/17/2016
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 BROADWAY FL 6
SEATTLE WA
98122-5330
US
IV. Provider business mailing address
601 BROADWAY FL 6
SEATTLE WA
98122-5330
US
V. Phone/Fax
- Phone: 206-386-2600
- Fax: 206-622-1644
- Phone: 206-386-2600
- Fax: 206-622-1644
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | MT211069 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | A164618 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XS0114X |
| Taxonomy | Adult Reconstructive Orthopaedic Surgery Physician |
| License Number | MD61336987 |
| License Number State | WA |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | MD61336987 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: