Individual
AMITAVA MICHAEL DASGUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1401 MADISON AVE, COVINGTON, KY 41011-3313
(859) 655-6100
(573) 882-6228
Mailing address
215 E 11TH ST, NEWPORT, KY 41071-2203
(859) 655-6100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
57201
KY
207QG0300X
Geriatric Medicine (Family Medicine) Physician
201636529
MO
207QG0300X
Geriatric Medicine (Family Medicine) Physician
57201
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57201
KY LICENSE
KY
Enumeration date
04/05/2012
Last updated
01/09/2023
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