Physician Compare National (NPI:1538180211)

HEALTHCARE PROVIDER: RAJAN GUPTA MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1538180211
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5991770919
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120227000745
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GUPTA
	Individual professional last name
Provider First Name	RAJAN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1986
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GASTROENTEROLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GASTROENTEROLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	241 SINGLETON RIDGE RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE A
	Group Practice or individual's line 2 address
City	CONWAY
	Group Practice or individual's city
State	SC
	Group Practice or individual's state
Zip Code	295269136
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	420085
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GRAND STRAND REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y