Individual
MAYANK GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
34515 9TH AVE S, FEDERAL WAY, WA 98003-6761
(253) 426-6341
(253) 426-6344
Mailing address
34515 9TH AVE S, FEDERAL WAY, WA 98003-6761
(253) 426-6341
(253) 426-6344
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD61054953
WA
208M00000X
Hospitalist Physician
Primary
MD61054953
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2165654
—
WA
Enumeration date
05/04/2016
Last updated
01/26/2021
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