Individual
DR. POOJA GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
880 MADISON AVE, MEMPHIS, TN 38103-3409
(901) 545-6969
(901) 545-4748
Mailing address
900 MAIN ST STE 630, PEORIA, IL 61602-5024
(309) 672-4433
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2006013138
MO
207RP1001X
Pulmonary Disease Physician
6462
NE
207RP1001X
Pulmonary Disease Physician
Primary
66968
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036123061
LICENSE
IL
Enumeration date
05/17/2007
Last updated
01/26/2023
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