Individual
MADHUR GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11200 GOVERNOR MANLY WAY, SUITE 205, RALEIGH, NC 27614-8599
(919) 570-7700
Mailing address
2000 PERIMETER PARK DR STE 200, MORRISVILLE, NC 27560-8442
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2008-01811
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508F
BCBS
NC
05
—
5910699
—
NC
Enumeration date
11/07/2008
Last updated
05/10/2021
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