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General NPI Number Information
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NPI Number | 1760485346
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Entity Type | Individual
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Provider Name | VINEET KUMAR GUPTA M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 01/31/2020
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Provider Practice Location Address
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Address Line | 1200 N ELM ST PEDIATRIC CRITICAL CARE SERVICES
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City | GREENSBORO
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State | NC
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Zip | 27401-1004
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Country | US
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Telephone | 419-262-7428
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Fax |
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Provider Business Mailing Address
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Address Line | 7602 BRAELANDS DR
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City | SUMMERFIELD
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State | NC
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Zip | 27358-9363
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Country | US
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Telephone | 419-262-7428
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 35.084463
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 208000000X
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License Number State | OH
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