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Individual

DR. PANKAJ CHAND GUPTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5890 MAYFAIR RD, NORTH CANTON, OH 44720-1547
(330) 305-2200
(330) 305-2210
Mailing address
5890 MAYFAIR RD, NORTH CANTON, OH 44720-1547
(330) 305-2200
(330) 305-2210

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
227967
MA
207W00000X
Ophthalmology Physician
Primary
35-099606
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0069769
OH
01
P01168884
MEDICARE RAILROAD
OH
Enumeration date
01/18/2007
Last updated
12/09/2020
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