Individual
AMITAVA GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
315 E BROADWAY, STE 195, LOUISVILLE, KY 40202-1703
(502) 629-4263
(502) 629-4282
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
30598
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000507565
ANTHEM - LAH
KY
01
—
00023026O
HUMANA - LAH
KY
01
—
072694
SIHO - LAH
KY
01
—
0733812
CIGNA - LAH
KY
05
—
100139950
—
IN
01
—
2734973000
PASSPORT ADVANTAGE - LAH
KY
01
—
50011055
PASSPORT - LAH
KY
05
—
64305980
—
KY
01
—
P00389564
RAILROAD MEDICARE
KY
Enumeration date
04/20/2006
Last updated
04/11/2024
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