Individual
PUSHPENDER GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
888 SWIFT BLVD, RICHLAND, WA 99352
(509) 942-2148
Mailing address
2318 CLOVERDALE AVE, 2318D CLOVERDALE APARTMENT, WINSTON SALEM, NC 27103-2053
(336) 287-9686
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD60579571
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891915921
NPI
WA
Enumeration date
07/23/2009
Last updated
08/24/2018
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