Healthcare Provider Details

I. General information

NPI: 1437512027
Provider Name (Legal Business Name): AKASH KISHORE GUPTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2016
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10207 CERNY ST STE 102
RALEIGH NC
27617-4880
US

IV. Provider business mailing address

10207 CERNY ST STE 102
RALEIGH NC
27617-4880
US

V. Phone/Fax

Practice location:
  • Phone: 919-613-2243
  • Fax:
Mailing address:
  • Phone: 919-613-2243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number2025-02101
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: