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Individual

AVNEESH GUPTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1500 E MEDICAL CENTER DRIVE, 2ND FLOOR UNIVERSITY HOSPITAL RECP PATHOLOGY, ANN ARBOR, MI 48109-5054
(800) 862-7284
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047

Taxonomy

Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
4301083130
MI
207ZP0101X
Anatomic Pathology Physician
Primary
4301083130
MI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
41208
AZ
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
4301083130
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ZWCMBF
MEDICARE GROUP NUMBER
AZ
Enumeration date
05/17/2007
Last updated
08/21/2012
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