Individual
DR. JONATHAN GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
44405 WOODWARD AVE, PONTIAC, MI 48341-5023
(248) 858-3000
Mailing address
32640 WHATLEY RD, FRANKLIN, MI 48025-1123
(248) 390-0579
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
331821
NY
2085R0202X
Diagnostic Radiology Physician
Primary
4301099446
MI
208D00000X
General Practice Physician
4301099446
MI
Other
Enumeration date
07/19/2011
Last updated
08/26/2024
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