Individual
CHERYL GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3820 W BLUEMOUND RD, SUITE 125, WAUWATOSA, WI 53213
(414) 302-3800
(414) 302-3813
Mailing address
1211 MARINA DR, GRAFTON, WI 53024-9334
(414) 375-7867
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
54224
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/23/2008
Last updated
04/26/2012
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