MEDICARE: NEETU GUPTA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	54386	TN
2	207VX0000X	Obstetrics Physician	35.143891	OH
3	207V00000X	Obstetrics & Gynecology Physician	01099042A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194012484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEETU GUPTA MD

Provider Business Mailing Address
First Line	:	1 PRESTIGE PL STE 550
Second Line	:
City	:	MIAMISBURG
State	:	OH
Zip	:	45342-6115
Country	:	US
Telephone Number	:	937-762-1310
Fax Number	:

Provider Business Practice Location Address
First Line	:	3535 PENTAGON BLVD STE 220
Second Line	:
City	:	BEAVERCREEK
State	:	OH
Zip	:	45431-1705
Country	:	US
Telephone Number	:	937-429-7350
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2011
Last Update Date	:	04/07/2026

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Directions to “ NEETU GUPTA MD” Practice Location

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