Individual
DR. PRATEEK KUMAR GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
1355 W BRIERBROOK RD, GERMANTOWN, TN 38138-2208
(901) 390-2930
(901) 390-2940
Mailing address
1375 W BRIERBROOK RD, GERMANTOWN, TN 38138-2208
(901) 390-2930
(901) 390-2940
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
25809
MS
2086S0129X
Vascular Surgery Physician
Primary
51677
TN
2086S0129X
Vascular Surgery Physician
E11572
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01303031
—
MS
05
—
208461001
—
AR
01
—
6026580
BCBS
TN
05
—
Q009116
—
TN
Enumeration date
11/07/2008
Last updated
01/22/2025
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