Individual
DR. AVNI GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.B.B.S.
Contact information
Practice address
4922 LANIER AVE APT A, BALTIMORE, MD 21215-5344
(443) 514-4429
Mailing address
5198 RELIABLE PKWY, CHICAGO, IL 60686-0051
(800) 444-6110
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036132136
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
036132136
IL
208VP0014X
Interventional Pain Medicine Physician
036132136
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036132136
—
IL
01
—
P01354089
RAILROAD
IL
Enumeration date
08/21/2008
Last updated
05/04/2016
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