Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 04-39156 | KS |
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 2013002794 | MO |
N | 207RC0000X | Internist - Cardiovascular Disease | ME123490 | FL |
NPI | 1437314903 |
---|---|
Provider Name | Bhanu Prakash Gupta |
First Address | Kansas City, KS 66160-8500 |
Second Address | Kansas City, KS 66160-8500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2008 |
Last Update Date | 11/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
038A00020 | MEDICARE (01) | MO |
038B00046 | MEDICARE (01) | KS |
038E00030 | MEDICARE (01) | MO |
1437314903 | (05) | MO |
201136290B | (05) | KS |
ENROLLED | (05) | IA |
ENROLLED | (05) | MN |
P00733637 | MEDICARE RAILROAD (01) | MN |