Gupta, Veena Kawatra
Gupta, Veena Kawatra is an individual health care provider with primary practice located at 3307 Broadway St Ste 140, Mount Vernon IL 62864-2347. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Gupta, Veena Kawatra can be contacted via phone (618) 244-7200.Contact Information
Primary practice address
3307 Broadway St Ste 140
Mount Vernon IL 62864-2347
Phone: (618) 244-7200
Fax: (618) 244-7274
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036065879 | Illinois |
Profile Details
| NPI number | 1790713899 |
|---|---|
| LBN Legal business name | Gupta, Veena Kawatra |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2006 |
| Last updated | Feb 24th, 2015 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790713899 | NPPES |
| Illinois | MEDICAID | 036065879 |
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