MEDICARE: DR. PANKAJ CHAND 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
1	207W00000X	Ophthalmology Physician	227967	MA
2	207W00000X	Ophthalmology Physician	35-099606	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01168884	OTHER	OH	MEDICARE RAILROAD

Other Identifiers

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

General Provider Information

NPI Number	:	1609929371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PANKAJ CHAND GUPTA M.D.

Provider Business Mailing Address
First Line	:	5890 MAYFAIR RD
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-1547
Country	:	US
Telephone Number	:	330-305-2200
Fax Number	:	330-305-2210

Provider Business Practice Location Address
First Line	:	5890 MAYFAIR RD
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-1547
Country	:	US
Telephone Number	:	330-305-2200
Fax Number	:	330-305-2210

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

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	12/09/2020

Similar Medicare Providers

1174831218 — CANTON PHYSICAL MEDICARE, LLC
Practice Location Address:

2050 CUMMING HWY , SUITE 100
CANTON, GA
30114-8614

Practice Phone: 770-345-9600
Practice Fax:

1679515282 — PHILIP C ROHOLT M.D.
Practice Location Address:

5890 MAYFAIR RD
CANTON, OH
44720-1547

Practice Phone: 330-305-2200
Practice Fax: 330-305-3310

1609818244 — ROHOLT VISION INSTITUTE INC
Practice Location Address:

5890 MAYFAIR RD
CANTON, OH
44720-1547

Practice Phone: 330-305-2200
Practice Fax: 330-305-2210

1922044023 — DAVID P RONCONE O.D.
Practice Location Address:

5890 MAYFAIR RD
CANTON, OH
44720-1547

Practice Phone: 330-305-2200
Practice Fax: 330-305-2210

1013953116 — DR. BRIAN M MATHIE O.D.
Practice Location Address:

5890 MAYFAIR RD
CANTON, OH
44720-1547

Practice Phone: 330-305-2200
Practice Fax: 330-305-2210

1538361159 — THOMAS A. WOHL MD
Practice Location Address:

5890 MAYFAIR RD
NORTH CANTON, OH
44720-1547

Practice Phone: 330-305-2200
Practice Fax: 330-305-2210

Directions to “ DR. PANKAJ CHAND GUPTA M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.