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Individual

DR. RICHA GUPTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1110 BROAD AVE, SUITE 500, GULFPORT, MS 39501-8907
(228) 575-2588
(228) 864-4154
Mailing address
1110 BROAD AVE, SUITE 500, GULFPORT, MS 39501-8907
(228) 575-2588
(228) 864-4154

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2007006085
MO
207RR0500X
Rheumatology Physician
Primary
22001
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03575076
MS
Enumeration date
07/31/2008
Last updated
02/17/2016
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