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Individual

ASEEM A GUPTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2301 S BROAD ST, SUITE 205A, PHILADELPHIA, PA 19148-3542
(215) 952-9323
(215) 952-1246
Mailing address
2301 S BROAD ST, SUITE 205A, PHILADELPHIA, PA 19148-3542

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD439646
PA
207L00000X
Anesthesiology Physician
MT186038
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102440000
PA
Enumeration date
03/26/2007
Last updated
03/07/2012
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