Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 35083146 | OH |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 35083146 | OH |
NPI | 1124095823 |
---|---|
Provider Name | Madhukar Gupta |
First Address | Cincinnati, OH 45242-5644 |
Second Address | Cincinnati, OH 45249-2309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2006 |
Last Update Date | 24/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000310785 | ANTHEM (01) | |
1519679400 | WORKMANS COMP (01) | |
200503740 | (05) | IN |
2435805 | (05) | OH |
2503778 | UNITED (01) | |
283830 | AMERIGROUP (01) | |
64088099 | (05) | KY |
H93215 | (02) |