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NPI Code Detail

MEDICARE: DR. GOPAL K GUPTA MD

MEDICARE: DR. GOPAL K 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
12080N0001XNeonatal-Perinatal Medicine Physician152950MA

Other Identifiers

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

General Provider Information

NPI Number : 1275513681
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GOPAL K GUPTA MD
Provider Business Mailing Address
First Line : 799 CONCORD AVE # DOOR4
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-1048
Country : US
Telephone Number : 617-491-5111
Fax Number : 617-491-5222
Provider Business Practice Location Address
First Line : 799 CONCORD AVE # DOOR4
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-1048
Country : US
Telephone Number : 617-491-5111
Fax Number : 617-491-5222
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2006
Last Update Date : 10/03/2013

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