Individual
RAJ R GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1826 VETERANS BLVD, MACON, GA 31021
(478) 272-1210
Mailing address
PO BOX 13026, MACON, GA 31208-3026
(478) 741-4588
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
024819
GA
Other
Enumeration date
10/11/2006
Last updated
07/08/2007
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