Provider Demographics
NPI:1659370005
Name:GUPTA, ANEETA JAIN (MD)
Entity Type:Individual
Prefix:
First Name:ANEETA
Middle Name:JAIN
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HOSPITAL DR STE 1A
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-5248
Mailing Address - Country:US
Mailing Address - Phone:828-684-1119
Mailing Address - Fax:828-684-1184
Practice Address - Street 1:50 HOSPITAL DR
Practice Address - Street 2:SUITE 1 A
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5248
Practice Address - Country:US
Practice Address - Phone:828-684-1119
Practice Address - Fax:828-684-1184
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2001012102084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC132WEOtherBCBS
NC89132WEMedicaid
130026105OtherRAILROAD MEDICARE B
NC132WEOtherBCBS
2009645AMedicare PIN