Individual
DR. ASHISH K GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1399 JENKS AVE # 12, PANAMA CITY, FL 32401-2442
(850) 532-6303
(850) 307-5402
Mailing address
1399 JENKS AVE # 12, PANAMA CITY, FL 32401-2442
(850) 532-6303
(850) 307-5402
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
ME113628
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010517300
—
FL
01
—
31895
FLORIDA BLUE
FL
01
—
P01249310
RAILROAD MEDICARE
FL
Enumeration date
10/13/2006
Last updated
09/16/2019
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