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General NPI Number Information
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NPI Number | 1669640314
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Entity Type | Organization
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Legal Business Name | ARUN GUPTA MD PC
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Dates
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Enumeration Date | 02/15/2008
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Last Update Date | 10/30/2019
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Provider Practice Location Address
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Address Line | 1094 N MONROE ST
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City | MONROE
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State | MI
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Zip | 48162-3193
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Country | US
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Telephone | 734-241-7162
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Fax | 734-241-9102
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Provider Business Mailing Address
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Address Line | 1094 N MONROE ST
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City | MONROE
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State | MI
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Zip | 48162-3193
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Country | US
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Telephone | 734-241-7162
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Fax | 734-241-9102
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Authorized Official
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Title or Position | PRESIDENT
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Name | ARUN GUPTA
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Credential | MD
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Telephone | 734-241-7162
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 4301047791
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License Number State | MI
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