Individual
DR. MANISH GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
205 SOUTH FRONT STREET, 8TH FLOOR BMA, HARRISBURG, PA 17104-1619
(717) 231-8700
(717) 231-8753
Mailing address
205 S FRONT ST FL 8, HARRISBURG, PA 17104-1619
(717) 231-8700
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036138105
IL
208600000X
Surgery Physician
Primary
MD062496L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036138105
—
IL
Enumeration date
06/29/2006
Last updated
12/20/2022
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