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Individual

DR. SAURABH GUPTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
3401 CIVIC CENTER BLVD, DEPARTMENT OF PEDIATRIC RADIOLOGY, PHILADELPHIA, PA 19104-4319
(215) 590-2564
(267) 425-7195
Mailing address
3401 CIVIC CENTER BLVD, DEPARTMENT OF PEDIATRIC RADIOLOGY, PHILADELPHIA, PA 19104-4319
(215) 590-1190

Taxonomy

Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
MT208783
PA
2085R0202X
Diagnostic Radiology Physician
57276
WI

Other

Enumeration date
09/24/2011
Last updated
06/29/2015
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