Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 50669 | KY |
N | 208200000X | Surgeon | MT193557 | PA |
N | 208600000X | Surgeon | MT193557 | PA |
NPI | 1851553168 |
---|---|
Provider Name | Meera Gupta |
First Address | Lexington, KY 40536-0284 |
Second Address | Lexington, KY 40536-4206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2008 |
Last Update Date | 30/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
50669 | KENTUCKY MEDICAL LICENSE (01) | KY |