Organization
PAWAN K GUPTA MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAWAN K GUPTA MD (OWNER)
(814) 943-3600
Entity
Organization
Contact information
Practice address
2613 8TH AVE, STE 4B, ALTOONA, PA 16602
(814) 943-3600
(814) 943-3675
Mailing address
2613 8TH AVE, STE 4B, ALTOONA, PA 16602
(814) 943-3600
(814) 943-3675
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD066182L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018323610002
—
PA
Enumeration date
10/23/2006
Last updated
08/22/2020
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