Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 2012011807 | MO |
NPI | 1225382302 |
---|---|
Provider Name | Sumit Kumar Gupta |
First Address | Kansas City, MO 64184-3966 |
Second Address | Columbia, MO 65201-0000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2012 |
Last Update Date | 29/04/2019 |