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Individual

DR. RAHUL GUPTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12 EXECUTIVE PARK DR NE STE 300, DEPARTMENT OF PSYCHIATRY, ATLANTA, GA 30329-2206
(404) 727-3886
Mailing address
139 RENAISSANCE PKWY NE, ATLANTA, GA 30308-2324
(404) 874-2224

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
072680
GA
2084P0802X
Addiction Psychiatry Physician
072680
GA

Other

Enumeration date
06/21/2010
Last updated
01/25/2017
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