Individual
MADHUKAR GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11140 MONTGOMERY RD, CINCINNATI, OH 45249-2309
(513) 792-7800
(513) 792-7807
Mailing address
4380 MALSBARY RD, SUITE 200, CINCINNATI, OH 45242-5644
(513) 366-4488
(513) 366-4480
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35083146
OH
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
35083146
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000310785
ANTHEM
—
01
—
1519679400
WORKMANS COMP
—
05
—
200503740
—
IN
05
—
2435805
—
OH
01
—
2503778
UNITED
—
01
—
283830
AMERIGROUP
—
05
—
64088099
—
KY
Enumeration date
03/02/2006
Last updated
10/24/2020
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