Individual
HIMANSHU GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-4011
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
23960
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009955015
—
AL
05
—
009955025
—
AL
05
—
009955035
—
AL
01
—
051522450
BLUE CROSS
AL
01
—
051522451
BLUE CROSS
AL
01
—
051522452
BLUE CROSS
AL
01
—
09339574
MISSISSPPI MEDICAID
MS
01
—
P00175461
RAILROAD MEDICARE
AL
Enumeration date
06/17/2006
Last updated
09/27/2010
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