Individual
SONU GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 RIVER PL, BRASELTON, GA 30517-5600
(770) 848-8000
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125060842
IL
208M00000X
Hospitalist Physician
79664
GA
261QP2300X
Primary Care Clinic/Center
Primary
79664
GA
Other
Enumeration date
07/09/2012
Last updated
02/06/2024
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