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NPI Code Detail

MEDICARE: DR. VINEET KUMAR GUPTA M.D.

MEDICARE: DR. VINEET KUMAR 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 Physician35.084463OH
22080P0203XPediatric Critical Care Medicine Physician208000000XOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
135084463OTHEROHOHIO LICENSE #
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760485346
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VINEET KUMAR GUPTA M.D.
Provider Business Mailing Address
First Line : 7602 BRAELANDS DR
Second Line :
City : SUMMERFIELD
State : NC
Zip : 27358-9363
Country : US
Telephone Number : 419-262-7428
Fax Number :
Provider Business Practice Location Address
First Line : 1200 N ELM ST
Second Line : PEDIATRIC CRITICAL CARE SERVICES
City : GREENSBORO
State : NC
Zip : 27401-1004
Country : US
Telephone Number : 419-262-7428
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 01/31/2020

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