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NPI Code Detail

MEDICARE: RAJAT GUPTA MD

MEDICARE:   RAJAT  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
12085R0204XVascular & Interventional Radiology Physician01056645AIN
22085R0202XDiagnostic Radiology Physician01056645AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00387639OTHERINRR MEDICARE PINS
4P00147569OTHERINRAILROAD MEDICARE
5P00177625OTHERINRR MEDICARE PINS
6P00364623OTHERINRR MEDICARE PINS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2000000342004OTHERINANTHEM
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265426845
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAJAT GUPTA MD
Provider Business Mailing Address
First Line : 9998 CROSSPOINT BLVD STE 200
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-3307
Country : US
Telephone Number : 317-579-2150
Fax Number : 317-579-2130
Provider Business Practice Location Address
First Line : 9998 CROSSPOINT BLVD STE 200
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-3307
Country : US
Telephone Number : 317-579-2150
Fax Number : 317-579-2130
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2005
Last Update Date : 12/29/2020

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Directions to “ RAJAT GUPTA MD” Practice Location

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