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NPI Code Detail

MEDICARE: OLGA THERESA GUPTA M.D.

MEDICARE: OLGA THERESA GUPTA M.D.
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
1208000000XPediatrics Physician229884MA
2208000000XPediatrics PhysicianMD421816PA
32080P0205XPediatric Endocrinology Physician229884MA
42080P0205XPediatric Endocrinology PhysicianMD421816PA
52080P0205XPediatric Endocrinology Physician202201179NC

General Provider Information

NPI Number : 1386673267
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLGA THERESA GUPTA M.D.
Provider Business Mailing Address
First Line : 3000 ERWIN RD
Second Line :
City : DURHAM
State : NC
Zip : 27705-4504
Country : US
Telephone Number : 919-684-3772
Fax Number : 919-684-8613
Provider Business Practice Location Address
First Line : 3000 ERWIN RD
Second Line :
City : DURHAM
State : NC
Zip : 27705-4504
Country : US
Telephone Number : 919-684-3772
Fax Number : 919-684-8613
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2006
Last Update Date : 08/23/2023

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