Individual
PUNEET GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1225 S GEAR AVE, STE 254, WEST BURLINGTON, IA 52655-1691
(319) 768-3321
Mailing address
PO BOX 540, WEST BURLINGTON, IA 52655-0540
(319) 768-3450
(319) 768-3460
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001797
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01149
WELLMARK BLUE CROSS BLUE
—
01
—
252993
MIDLANDS CHOICE
—
01
—
P00407816
RR MEDICARE
IA
Enumeration date
03/20/2007
Last updated
11/19/2007
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