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General NPI Number Information
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NPI Number | 1023257193
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Entity Type | Organization
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Legal Business Name | ANIL K GUPTA M D PLC
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Dates
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Enumeration Date | 02/13/2009
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Last Update Date | 05/25/2011
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Provider Practice Location Address
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Address Line | 32121 WOODWARD AVE STE 203
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City | ROYAL OAK
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State | MI
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Zip | 48073-6237
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Country | US
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Telephone | 248-549-9035
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Fax | 248-549-9407
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Provider Business Mailing Address
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Address Line | 2798 CREEK RD
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City | TROY
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State | MI
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Zip | 48098
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Country | US
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Telephone | 248-641-8033
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. ANIL K GUPTA
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Credential | M.D.
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Telephone | 248-549-9035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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