Provider Demographics
NPI:1083398101
Name:GUPTA, AMIT (MD)
Entity Type:Individual
Prefix:
First Name:AMIT
Middle Name:
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NORTH ALABAMA MEDICAL CENTER IM RESIDENCY
Mailing Address - Street 2:1701 VETERANS DRIVE
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630
Mailing Address - Country:US
Mailing Address - Phone:256-629-1950
Mailing Address - Fax:256-629-2765
Practice Address - Street 1:NORTH ALABAMA MEDICAL CENTER IM RESIDENCY
Practice Address - Street 2:1701 VETERANS DRIVE
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630
Practice Address - Country:US
Practice Address - Phone:256-629-1950
Practice Address - Fax:256-629-2765
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2024-02-06
Deactivation Date:2024-01-12
Deactivation Code:
Reactivation Date:2024-02-06
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program