SURYA N GUPTA (NPI# 1487643342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487643342 |
| Entity Type | Individual |
| Full Name | SURYA N GUPTA |
| Credential | MD |
| Practice Address |
4803 Kentucky Street Camc Pediatric Neurology South Charleston WV 25309-1547 |
| Mailing Address |
Po Box 1547 Camc Pediatric Neurology Charleston WV 25326-1547 |
| Practice Telephone | 3047667695 |
| Practice Fax Number | 6036633229 |
| Mailing Telephone | 3043887183 |
| Mailing Fax Number | 3043887176 |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2013-07-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080P0008X |
Pediatrics Specialization: Neurodevelopmental Disabilities |
MD057895L | PA | Allopathic & Osteopathic Physicians |
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
15026 | NH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0016630190001 | 05 |
| Street Address |
4803 KENTUCKY STREET CAMC PEDIATRIC NEUROLOGY |
| City | SOUTH CHARLESTON |
| State | WV |
| Zip Code | 25309-1547 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376905 | Lovie Bradshaw | Technician | 4823 Tennessee St., South Charleston, WV 25309 | 2020-11-03 |
| 1306447735 | Barbara Mackenzie | Technician | 4224 Kanawha Turnpike, South Charleston, WV 25309 | 2020-11-03 |
| 1548861974 | Sarah Nichols | Technician | 4990 Colonial Park Dr. Apt. F, South Charleston, WV 25309 | 2020-11-03 |
| 1629690177 | Jennifer Mabry-goins | Technician | 4505 River Avenue, S Charleston, WV 25309 | 2020-05-07 |
| 1811537715 | Brandon C Dean | Psychologist | 4857 Macorkle Ave. Sw, South Charleston, WV 25309 | 2020-01-09 |
| 1467096057 | Linda Mullins | Technician | 60 Hayvon Lane, South Charleston, WV 25309 | 2019-11-06 |
| 1831743616 | Ann Myriah Beck | Nurse Practitioner | 4610 Maccorkle Ave Sw # 300, South Charleston, WV 25309 | 2019-07-30 |
| 1942671227 | Edward W Eskew | Family Medicine | 4605 Maccorkle Avenue, Sw, Thspp-psychiatry, South Charleston, WV 25309 | 2015-10-13 |
| 1720468218 | Link Investments LLC | Pharmacy | 5151 Macorkle Avenue, South Charleston, WV 25309 | 2015-06-01 |
| 1366840951 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 304 Southbridge Blvd., S.ccharleston, WV 25309 | 2014-12-12 |
| Find all providers in zip 25309 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891182036 | Azara Sneha Singh | Psychiatry & Neurology | 830 Pennsylvania Ave Ste 201, Charleston, WV 25302-3389 | 2015-04-24 |
| 1598798860 | Monique Kossak Gingold | Psychiatry & Neurology | 816 Somerset St, Morgantown, WV 26505-2111 | 2006-07-09 |
| 1508097395 | Zaid Abed Al-kariem A. Al-qudah | Psychiatry & Neurology | 527 Medical Park Dr Ste 204, Bridgeport, WV 26330-9009 | 2009-07-28 |
| 1225264203 | John Lawson Magruder | Psychiatry & Neurology | 1 Medical Center Drive, Morgantown, WV 26506 | 2009-06-04 |
| 1316138324 | Mary S Payne | Psychiatry & Neurology | 1600 Medical Center Dr, Ste B500, Huntington, WV 25701-3656 | 2007-08-05 |
| 1558390823 | Paul Douglas Knowles | Psychiatry & Neurology | 1600 Medical Center Dr, B500, Huntington, WV 25701-3656 | 2006-06-30 |
| City | SOUTH CHARLESTON |
| Zip Code | 25309 |
Please comment or provide details below to improve the information on SURYA N GUPTA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.