Organization
RAVI GUPTA,M.D.,S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAVI GUPTA M.D. (PRESIDENT)
(414) 475-5800
Entity
Organization
Contact information
Practice address
10625 W NORTH AVE STE 230, WAUWATOSA, WI 53226-2315
(414) 475-5800
(414) 475-5825
Mailing address
10625 W NORTH AVE STE 230, WAUWATOSA, WI 53226-2315
(414) 475-5800
(414) 475-5825
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20918
WI
Other
Enumeration date
07/30/2008
Last updated
07/30/2008
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