Organization
ASHISH GUPTA MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHISH GUPTA MD (OWNER)
(734) 283-7248
Entity
Organization
Contact information
Practice address
2070 BIDDLE AVE, SUITE 1, WYANDOTTE, MI 48192-4080
(734) 283-7248
(734) 283-2937
Mailing address
1627 MOMENTUM PL, CHICAGO, IL 60689-5316
(734) 283-7248
(734) 283-2937
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00248151
MEDICARE RAILROAD
—
Enumeration date
10/25/2006
Last updated
02/25/2015
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