Provider Demographics
NPI:1194990945
Name:GUPTA, SANDEEP S (MD)
Entity type:Individual
Prefix:
First Name:SANDEEP
Middle Name:S
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2730 PIERCE ST
Mailing Address - Street 2:SUITE 401
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-3796
Mailing Address - Country:US
Mailing Address - Phone:712-255-8827
Mailing Address - Fax:712-255-4862
Practice Address - Street 1:2730 PIERCE ST
Practice Address - Street 2:SUITE 401
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-3796
Practice Address - Country:US
Practice Address - Phone:712-255-8827
Practice Address - Fax:712-255-4862
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN8921207RP1001X
IAMD-42675207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease