Gupta, Ajay S
Gupta, Ajay S is an individual health care provider with primary practice located at 7956 W Jefferson Blvd , Fort Wayne IN 46804-4140. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Gupta, Ajay S can be contacted via phone (260) 436-2416.Contact Information
Primary practice address
7956 W Jefferson Blvd
Fort Wayne IN 46804-4140
Phone: (260) 436-2416
Fax: (260) 436-9662
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 01037375A | Indiana |
Profile Details
| NPI number | 1487651873 |
|---|---|
| LBN Legal business name | Gupta, Ajay S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2005 |
| Last updated | Oct 5th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487651873 | NPPES |
| Ohio | MEDICAID | 0839507 | |
| Ohio | MEDICAID | 100258670 | |
| Ohio | MEDICAID | 4596849 | |
| Ohio | Other | 130023781 |
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