Main Street Family Medicine of Spring Grove, Inc.

Organization Active NPI Family Medicine Physician · Spring Grove, PA

NPI 1508915844 · NPPES record last updated Dec 10, 2007

Key facts

NPI
1508915844
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
OS010558L (PA)
Legal business name
MAIN STREET FAMILY MEDICINE OF SPRING GROVE, INC.
Practice address
285 N Main St
Spring Grove, PA 17362-1134
Phone
(717) 225-3610
Fax
(717) 225-7294
NPI assigned
Jan 9, 2007
Organization subpart
No

Authorized official

Name
Dr. Puneet Kumar Gupta, D.O.
Title
Physician
Phone
(717) 225-3610

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X OS010558L PA Yes

Addresses

Primary practice location

285 N Main St
Spring Grove, PA 17362-1134

Mailing address

285 N Main St
Spring Grove, PA 17362-1134
Phone (717) 225-3610

Other providers in Spring Grove, PA

All providers in Spring Grove, PA · Family Medicine Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.