Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 28164 | WV |
NPI | 1073744421 |
---|---|
Provider Name | Dr. Shipra Gupta |
First Address | Morgantown, WV 26506-1200 |
Second Address | Morgantown, WV 26506-1200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2009 |
Last Update Date | 09/01/2021 |