Individual
ANJALI GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2460 NW STEWART PKWY, SUITE 102, ROSEBURG, OR 97471-1516
(541) 677-2494
Mailing address
2460 NW STEWART PKWY, SUITE 102, ROSEBURG, OR 97471-1516
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD61204532
WA
207RN0300X
Nephrology Physician
MD167029
OR
207RN0300X
Nephrology Physician
Primary
MD61204532
WA
208M00000X
Hospitalist Physician
61-003355
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03126478
—
NY
Enumeration date
09/08/2008
Last updated
11/10/2021
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