Individual
SAURABH GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-6970
Mailing address
101 E. OLNEY AVE, PROVIDER ENROLLMENT, SUITE 400, PHILADELPHIA, PA 19120-2421
(215) 456-4695
(215) 456-5926
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD447197
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/27/2008
Last updated
03/17/2018
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