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NPI Code Detail

MEDICARE: DR. MONA RAJ GUPTA D.O.

MEDICARE: DR. MONA RAJ GUPTA D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician2007-00366NC

General Provider Information

NPI Number : 1902923691
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MONA RAJ GUPTA D.O.
Provider Business Mailing Address
First Line : 8304 CREEDMOOR RD
Second Line :
City : RALEIGH
State : NC
Zip : 27613-1697
Country : US
Telephone Number : 919-870-8409
Fax Number :
Provider Business Practice Location Address
First Line : 8304 CREEDMOOR RD
Second Line :
City : RALEIGH
State : NC
Zip : 27613-1697
Country : US
Telephone Number : 919-870-8409
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2007
Last Update Date : 02/26/2024

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