Individual
SHAKUN GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 E BROAD ST, RICHMOND, VA 23219-1930
(804) 828-2467
(804) 628-5847
Mailing address
PO BOX 780125, PHILADELPHIA, PA 19178-0125
(804) 922-4844
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101255560
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912163544
—
VA
Enumeration date
08/04/2008
Last updated
12/17/2024
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