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Individual

DR. NISHEETH GUPTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
929 RIDGE RD, SUITE 5, MUNSTER, IN 46321-1751
(219) 836-2000
Mailing address
200 E 89TH AVE, SUITE 2A, MERRILLVILLE, IN 46410-7319
(219) 736-2800
(219) 736-6680

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
01042940
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000085037
INDIANA CARPENTERS
IN
01
000000085037
UNICARE
05
100464750
IN
01
100464750A
MOLINA
01
254509
WELLCARE
01
830002223
TRAVELERS MEDICARE
01
9220968
ADVOCATE PHO
01
N254509
HARMONY HEALTH
Enumeration date
12/30/2005
Last updated
02/18/2013
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