# DR. RAJEEV GUPTA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1770731077
- **Gender:** Man
- **Credential:** MBBS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 67322 | WI | Yes |

## Other

- **Enumeration date:** 08/29/2008
- **Last updated:** 10/13/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100067612 | — | WI |
| 05 | — | 1770731077 | — | WI |
| 01 | — | K400392563 | MEDICARE | WI |