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NPI Code Detail

MEDICARE: DR. MAITREYEE M GUPTA M.D.

MEDICARE: DR. MAITREYEE M 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
1207RN0300XNephrology PhysicianMD451303PA

General Provider Information

NPI Number : 1952505810
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAITREYEE M GUPTA M.D.
Provider Business Mailing Address
First Line : 833 CHESTNUT ST STE 700
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19107-4410
Country : US
Telephone Number : 215-503-3000
Fax Number : 215-503-2506
Provider Business Practice Location Address
First Line : 833 CHESTNUT ST STE 700
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19107-4410
Country : US
Telephone Number : 215-503-3000
Fax Number : 215-503-2506
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2007
Last Update Date : 06/22/2019

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