Provider Demographics
NPI:1134190283
Name:GUPTA, ARADHANA (MD)
Entity type:Individual
Prefix:
First Name:ARADHANA
Middle Name:
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:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 MEDICAL PARK DR
Practice Address - Street 2:STE 300
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2982
Practice Address - Country:US
Practice Address - Phone:704-403-3676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200200538207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC566000156OtherGROUP TAX ID
NC2797082OtherCIGNA HEALTHCARE
NC41885OtherPARTNERS MEDICARE CHOICE
NC5902634Medicaid
NC185614OtherMEDCOST
NC14007OtherBCBS
NC5136653OtherAETNA
NCP00334821OtherRAILROAD MEDICARE
NC232009OtherMEDICARE
NC14007OtherBCBS
NC185614OtherMEDCOST