Individual
VISHAL GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
880 N TENNESSEE AVE STE 104, MARTINSBURG, WV 25401-9401
(304) 596-6893
Mailing address
PO BOX 67000, DEPARTMENT 272801, DETROIT, MI 48267-0002
(517) 817-7618
(517) 817-7639
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301093433
MI
207RG0100X
Gastroenterology Physician
Primary
33798
WV
207RG0100X
Gastroenterology Physician
4301093433
MI
Other
Enumeration date
12/12/2008
Last updated
03/02/2025
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