Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 0101242993 | VA |
NPI | 1023269867 |
---|---|
Provider Name | Mrs. Seema Gupta |
First Address | Huntington, WV 25704-9300 |
Second Address | Huntington, WV 25704-9300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2008 |
Last Update Date | 05/10/2010 |