Individual
DR. RAJEEV GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY, MILWAUKEE, WI 53215-3669
(414) 646-8900
(414) 646-8906
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
67322
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100067612
—
WI
05
—
1770731077
—
WI
01
—
K400392563
MEDICARE
WI
Enumeration date
08/29/2008
Last updated
10/13/2023
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