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NPI Code Detail

MEDICARE: DR. MUDIT GUPTA MD PHD

MEDICARE: DR. MUDIT GUPTA MD PHD
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 PhysicianMD467159PA
22080P0202XPediatric Cardiology PhysicianMD467159PA

General Provider Information

NPI Number : 1518316397
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MUDIT GUPTA MD PHD
Provider Business Mailing Address
First Line : 2929 ARCH ST FL 12
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-2857
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3401 CIVIC CENTER BLVD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4319
Country : US
Telephone Number : 215-590-4040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2016
Last Update Date : 01/28/2026

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Directions to “ DR. MUDIT GUPTA MD PHD” Practice Location

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