Individual
DR. SRINIVAS GUPTHA GUNTURU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 LEAD AVE SE, ALBUQUERQUE, NM 87106-5215
(505) 224-7000
(505) 224-7292
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5361
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
003583
NY
207RG0100X
Gastroenterology Physician
32961
WV
207RG0100X
Gastroenterology Physician
35C.003397
OH
207RG0100X
Gastroenterology Physician
Primary
MD2015-0453
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23429844
—
NM
Enumeration date
12/10/2008
Last updated
12/17/2025
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