Individual
MANJU GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 RIVER VALLEY BLVD, NEW RICHMOND, OH 45157-8566
(513) 553-3114
(513) 553-1032
Mailing address
424 WARDS CORNER RD STE 200, LOVELAND, OH 45140-6966
(513) 707-4041
(513) 576-1020
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
35044556
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0418766
—
OH
Enumeration date
11/14/2005
Last updated
09/10/2020
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