Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | OS9535 | FL |
Y | 207XS0106X | Orthopaedic Hand Surgeon | OS9535 | FL |
NPI | 1134146855 |
---|---|
Provider Name | Nirav Gupta |
First Address | Belfast, ME 04915-9074 |
Second Address | Ocala, FL 34471-7847 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 15/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
24419 | BCBS GROUP (01) | FL |
276069000 | (05) | FL |
56088 | BCBS (01) | FL |
DG5713 | MEICARE RR GROUP NUMBER (01) | FL |
I66326 | (02) | |
P00442268 | MEDICARE RR PTAN (01) | FL |