Individual
MICHELLE A GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 W 8TH AVE STE 100, SPOKANE, WA 99204-2307
(509) 474-5489
(509) 227-7070
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
(509) 227-7070
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
N/A
CA
2088P0231X
Pediatric Urology Physician
075711
GA
2088P0231X
Pediatric Urology Physician
Primary
MD60857749
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003177886A
—
GA
Enumeration date
05/03/2009
Last updated
12/30/2024
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