MEDICARE: SHUCHI 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	207Q00000X	Family Medicine Physician	159381	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	159381	OTHER	MA	TAHP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	710876	OTHER	MA	HPHC
4	J22618	OTHER	MA	BC/BS

General Provider Information

NPI Number	:	1487642732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHUCHI GUPTA MD

Provider Business Mailing Address
First Line	:	54 MILLER ST
Second Line	:	STE 300
City	:	QUINCY
State	:	MA
Zip	:	02169-4725
Country	:	US
Telephone Number	:	508-350-2350
Fax Number	:	508-350-2318

Provider Business Practice Location Address
First Line	:	54 MILLER ST
Second Line	:	SUITE 300
City	:	QUINCY
State	:	MA
Zip	:	02169-4725
Country	:	US
Telephone Number	:	617-481-3300
Fax Number	:	617-481-3305

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

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	08/06/2018

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Directions to “ SHUCHI GUPTA MD” Practice Location

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