Individual
NEAL RAJ GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1515 RIVER PL STE 200, BRASELTON, GA 30517-5603
(770) 848-6140
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8430
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
95560
GA
390200000X
Student in an Organized Health Care Education/Training Program
10909
GA
Other
Enumeration date
03/22/2019
Last updated
08/29/2023
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