Individual
SUDEEP GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1215 PLEASANT ST STE 206, DES MOINES, IA 50309-1419
(515) 875-9092
Mailing address
PO BOX 424, DES MOINES, IA 50302-0424
(515) 875-9092
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
03098
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0171769
—
IA
Enumeration date
08/05/2006
Last updated
10/15/2024
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