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General NPI Number Information
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NPI Number | 1386076248
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Entity Type | Individual
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Provider Name | ASHISH KUMAR GUPTA M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/02/2013
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 3901 BEAUBIEN ST
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City | DETROIT
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State | MI
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Zip | 48201-2119
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Country | US
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Telephone | 313-745-5638
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Fax | 313-745-5867
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Provider Business Mailing Address
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Address Line | 4201 SAINT ANTOINE ST UHC 5D - MAILBOX 226
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City | DETROIT
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State | MI
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Zip | 48201-2153
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Country | US
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Telephone | 313-966-5051
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Fax | 313-966-0665
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | MD15293
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 22759
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 4301117104
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License Number State | MI
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