Healthcare Provider Details

I. General information

NPI: 1003856998
Provider Name (Legal Business Name): ABHA R. GUPTA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABHA R. GUPTA MD

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 N JAMES RD
COLUMBUS OH
43219-1834
US

IV. Provider business mailing address

200 BRADENTON AVE
DUBLIN OH
43017-7515
US

V. Phone/Fax

Practice location:
  • Phone: 614-257-5200
  • Fax:
Mailing address:
  • Phone: 614-793-1980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number35-08-5561
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: