Individual
DR. SHAMINDER MOHAN GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1990 INDUSTRIAL BLVD, HOUMA, LA 70363-7055
(985) 868-9300
(985) 851-0053
Mailing address
1990 INDUSTRIAL BLVD, STE W480, HOUMA, LA 70363-7055
(985) 868-9300
(985) 851-0053
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
24216
LA
207RN0300X
Nephrology Physician
Primary
024216
LA
207RN0300X
Nephrology Physician
27111
MS
207RN0300X
Nephrology Physician
87357
GA
207RN0300X
Nephrology Physician
ME147819
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02223729
—
MS
05
—
1489697
—
LA
Enumeration date
06/09/2005
Last updated
11/30/2021
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