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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
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
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All providers in Spring Grove, PA · Family Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.