Individual
DR. MANOJ GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(910) 609-6439
Mailing address
PO BOX 1070, CHARLOTTE, NC 28201-1070
(800) 476-8646
(919) 382-3210
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891376Y
—
NC
01
—
E0449
MEDCOST # DR. GUPTA
NC
Enumeration date
07/21/2005
Last updated
07/09/2007
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