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General NPI Number Information
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NPI Number | 1578726477
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Entity Type | Individual
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Provider Name | SHUBHAM GUPTA M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 800 ROSE ST MS235
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City | LEXINGTON
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State | KY
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Zip | 40536-0001
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Country | US
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Telephone | 859-218-5771
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Fax | 859-323-1944
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Provider Business Mailing Address
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Address Line | 11100 EUCLID AVE STE 4554
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City | CLEVELAND
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State | OH
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Zip | 44106-1716
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Country | US
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Telephone | 216-285-5036
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Fax | 859-323-1944
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 709--L
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 47046
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 35.136851
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 2088F0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
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License Number | 47046
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License Number State | KY
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