Individual
DR. SANDEEP TRILOKCHANDRA GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.B., B.S.
Contact information
Practice address
6200 SHINGLE CREEK PKWY, SUITE 250, BROOKLYN CENTER, MN 55430-2128
(763) 544-0696
Mailing address
6200 SHINGLE CREEK PKWY STE 260, KIDNEY SPECIALISTS OF MN, MINNEAPOLIS, MN 55430-2128
(763) 561-5349
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
45546
MN
207RN0300X
Nephrology Physician
Primary
45546
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0075072
—
MT
01
—
1040994
PREFERRED ONE
MN
01
—
131379
UCARE
MN
01
—
31-00005
MEDICA PRIMARY
MN
01
—
31-00218
MEDICA CHOICE
MN
05
—
398618700
—
MN
01
—
HP41105
HEALTHPARTNERS
MN
Enumeration date
07/10/2006
Last updated
11/10/2020
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