Individual
RAKESH K GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 LINCOLN PARK BLVD, SUITE 100, KETTERING, OH 45429-3492
(937) 222-3118
(937) 222-1436
Mailing address
500 LINCOLN PARK BLVD, SUITE 100, KETTERING, OH 45429-3492
(937) 222-3118
(937) 222-1436
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
58339
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000005204
ANTHEM
—
01
—
0641931
PTAN
—
05
—
0746894
—
OH
01
—
310821503039
CARE SOURCE
—
01
—
3108215037B17
UNITED MINE WORKERS
—
01
—
390003522
UHC
—
01
—
661689
AETNA
—
01
—
D58339
HUMANA
—
Enumeration date
11/18/2005
Last updated
01/23/2017
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