Gupta, Veena Kawatra

Gupta, Veena Kawatra is an individual health care provider with primary practice located at 3307 Broadway St Ste 140, Mount Vernon IL 62864-2347. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Gupta, Veena Kawatra can be contacted via phone (618) 244-7200.

Contact Information

Primary practice address
3307 Broadway St Ste 140 Mount Vernon IL 62864-2347
Phone: (618) 244-7200
Fax: (618) 244-7274
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036065879 Illinois

Profile Details

NPI number 1790713899
LBN Legal business name Gupta, Veena Kawatra
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2006
Last updated Feb 24th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790713899 NPPES
Illinois MEDICAID 036065879

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