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Individual

DR. MAHESH GUPTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
310 BENEFIELD DR, SAVANNAH, GA 31406-2604
(912) 355-0798
Mailing address
1500 WHITNEY RD, SAVANNAH, GA 31406-2111
(912) 355-0798

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY001709
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000560667A
GA
Enumeration date
11/22/2006
Last updated
07/08/2007
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