Gupta, Surya N

Gupta, Surya N is an individual health care provider with primary practice located at 4803 Kentucky Street Camc Pediatric Neurology, South Charleston WV 25309-1547. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities, Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology. Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology is his primary health care specialty. Gupta, Surya N can be contacted via phone (304) 766-7695.

Contact Information

Primary practice address
4803 Kentucky Street Camc Pediatric Neurology South Charleston WV 25309-1547
Phone: (304) 766-7695
Fax: (603) 663-3229
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities 2080P0008X MD057895L Pennsylvania
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology 2084N0402X 15026 New Hampshire

Profile Details

NPI number 1487643342
LBN Legal business name Gupta, Surya N
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2005
Last updated Jul 18th, 2013 - about 11 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487643342 NPPES
Pennsylvania MEDICAID 0016630190001

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