Individual
SANDEEP GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
103 MCKNIGHT DR, SUITE A, MIDDLETOWN, OH 45044-4890
(513) 217-6400
(513) 217-6037
Mailing address
103 MCKNIGHT DR, SUITE A, MIDDLETOWN, OH 45044-4890
(513) 217-6400
(513) 217-6037
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35072259
OH
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
35072259
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000522400
ANTHEM BCBS
OH
01
—
2027989
MOLINA HEALTHCARE
OH
05
—
2027989
—
OH
01
—
208679830028
CARESOURCE
OH
01
—
283835
AMERIGROUP
OH
01
—
GU4106315
MEDICARE (OHIO) INDIVIDUAL NPI
OH
Enumeration date
03/02/2006
Last updated
11/21/2016
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