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General NPI Number Information
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NPI Number | 1699117101
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Entity Type | Individual
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Provider Name | SAMEER GUPTA MD
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Gender | Male
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Dates
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Enumeration Date | 07/25/2013
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 3131 E CLARENDON AVE STE 102
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City | PHOENIX
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State | AZ
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Zip | 85016-7069
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Country | US
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Telephone | 602-253-9168
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Fax | 602-251-3126
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Provider Business Mailing Address
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Address Line | 3000 ARLINGTON AVE STOP 1108
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City | TOLEDO
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State | OH
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Zip | 43614-2595
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Country | US
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Telephone |
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Fax |
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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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 35C.000928
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 35C.000928
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 036135491
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 76030
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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