Provider Demographics
NPI:1386673267
Name:GUPTA, OLGA THERESA (MD)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:THERESA
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OLGA
Other - Middle Name:THERESA
Other - Last Name:HARDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3000 ERWIN RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4504
Mailing Address - Country:US
Mailing Address - Phone:919-684-3772
Mailing Address - Fax:919-684-8613
Practice Address - Street 1:3000 ERWIN RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4504
Practice Address - Country:US
Practice Address - Phone:919-684-3772
Practice Address - Fax:919-684-8613
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229884208000000X, 2080P0205X
PAMD421816208000000X, 2080P0205X
NC2022011792080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics