Individual
MINI GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1700 HOSPITAL SOUTH DR, SUITE 304, AUSTELL, GA 30106-6810
(770) 732-8464
(770) 732-8462
Mailing address
1810 MULKEY RD, SUITE103, AUSTELL, GA 30106-1151
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
055949
GA
207RN0300X
Nephrology Physician
Primary
055949
GA
Other
Enumeration date
04/04/2006
Last updated
06/14/2022
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