Main Street Family Medicine of Spring Grove, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS010558L Issued in 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

Last updated

Dec 10, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Puneet Kumar Gupta, D.O.

Title

Physician

Phone

(717) 225-3610

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197244800000",
    "number": "1508915844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 N MAIN ST",
            "city": "SPRING GROVE",
            "state": "PA",
            "postal_code": "173621134",
            "telephone_number": "717-225-3610",
            "fax_number": "717-225-7294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 N MAIN ST",
            "city": "SPRING GROVE",
            "state": "PA",
            "postal_code": "173621134",
            "telephone_number": "717-225-3610",
            "fax_number": "717-225-7294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET FAMILY MEDICINE OF SPRING GROVE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-12-10",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "PUNEET",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "717-225-3610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS010558L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Spring Grove, PA
• Providers in Spring Grove, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.