Individual
DR. MANISH R GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1050 ISAAC STREETS DR, SUITE 136, OREGON, OH 43616-3291
(419) 696-5656
(419) 844-8784
Mailing address
1050 ISAAC STREETS DR, SUITE 136, OREGON, OH 43616-3291
(419) 696-5656
(419) 844-8784
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
35-07-6763-G
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2492922
—
OH
Enumeration date
12/23/2005
Last updated
02/06/2015
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