Provider Demographics
NPI:1154437176
Name:VED P. GUPTA, M.D., P.C.
Entity type:Organization
Organization Name:VED P. GUPTA, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:VED
Authorized Official - Middle Name:P
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-464-8008
Mailing Address - Street 1:2137 WELSH RD
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-4963
Mailing Address - Country:US
Mailing Address - Phone:215-464-8008
Mailing Address - Fax:215-464-7204
Practice Address - Street 1:2137 WELSH RD
Practice Address - Street 2:SUITE 2E
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-4963
Practice Address - Country:US
Practice Address - Phone:215-464-8008
Practice Address - Fax:215-464-7204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1789001OtherHIGHMARK BLUE SHIELD
PA2630521000OtherINDEPENDENCE BLUE CROSS
PA1789001OtherHIGHMARK BLUE SHIELD