Organization
MANISH RAJ GUPTA, MD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANISH RAJ GUPTA MD (PRESIDENT)
(419) 696-5656
Entity
Organization
Contact information
Practice address
1050 ISAAC STREETS DR, SUITE 136, OREGON, OH 43616-3291
(419) 696-5656
Mailing address
1050 ISAAC STREETS DR, SUITE 136, OREGON, OH 43616-3291
(419) 696-5656
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
35076763G
OH
Other
Enumeration date
10/02/2006
Last updated
07/31/2008
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