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General NPI Number Information
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NPI Number | 1275510901
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Entity Type | Individual
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Provider Name | SHASHI B. GUPTA M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/23/2005
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Last Update Date | 02/23/2009
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Provider Practice Location Address
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Address Line | 51339 NATIONAL RD E SUITE 12
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City | SAINT CLAIRSVILLE
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State | OH
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Zip | 43950-9119
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Country | US
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Telephone | 740-695-1210
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Fax | 740-695-4344
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Provider Business Mailing Address
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Address Line | 51339 NATIONAL RD E SUITE 12
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City | SAINT CLAIRSVILLE
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State | OH
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Zip | 43950-9119
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Country | US
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Telephone | 740-695-1210
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Fax | 740-695-4344
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35076216G
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 19728
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License Number State | WV
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