Individual
NITIN GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
24 JOLIET ST, DYER, IN 46311-1705
(219) 852-1524
(219) 933-2288
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
02006888A
IN
208M00000X
Hospitalist Physician
Primary
02006888A
IN
208M00000X
Hospitalist Physician
036.157126
IL
Other
Enumeration date
03/20/2018
Last updated
04/17/2025
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