Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | MD435529 | PA |
NPI | 1013171420 |
---|---|
Provider Name | Dr. Sameer Gupta |
First Address | Bryn Mawr, PA 19010-3231 |
Second Address | Bryn Mawr, PA 19010-3231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2008 |
Last Update Date | 05/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1031304690001 | (05) | PA |