Individual
AYUSHI GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1364 CLIFTON RD NE STE EG45, ATLANTA, GA 30322-1059
(913) 633-1545
Mailing address
207 13TH ST NE APT 902, ATLANTA, GA 30309-4590
(913) 633-1545
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
080453
GA
2085R0202X
Diagnostic Radiology Physician
Primary
080453
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123072700
—
MD
Enumeration date
06/06/2012
Last updated
11/20/2018
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