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General NPI Number Information
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NPI Number | 1588219026
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Entity Type | Organization
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Legal Business Name | GUPTA WELLNESS, INC
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Dates
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Enumeration Date | 08/01/2019
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Last Update Date | 08/01/2019
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Provider Practice Location Address
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Address Line | 8304 CREEDMOOR RD
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City | RALEIGH
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State | NC
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Zip | 27613-1697
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Country | US
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Telephone | 919-870-8409
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Fax |
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Provider Business Mailing Address
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Address Line | 8304 CREEDMOOR RD
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City | RALEIGH
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State | NC
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Zip | 27613-1697
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Country | US
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Telephone | 919-870-8409
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MONA RAJ GUPTA
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Credential | DO
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Telephone | 919-244-7645
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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