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Individual

BALDEV K GUPTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3700 WEST RD, TRENTON, MI 48183-2224
(734) 676-5600
(734) 676-5591
Mailing address
3700 WEST RD, TRENTON, MI 48183-2224
(734) 676-5600
(734) 676-5591

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301070829
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0829931
BLUECARE NETWORK
MI
01
110243955
RAILROAD MEDICARE
MI
01
1108299311
BLUE CROSS BLUE SHIELD
MI
05
4409445 10
MI
01
4684342
CIGNA HEALTHCARE
MI
01
6U4023
HAP
MI
01
7399359
AETNA
MI
Enumeration date
10/17/2006
Last updated
07/08/2007
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