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General NPI Number Information
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NPI Number | 1740424001
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Entity Type | Individual
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Provider Name | RASHIM K GUPTA MD
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Gender | Female
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Dates
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Enumeration Date | 04/29/2009
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Last Update Date | 09/03/2015
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Provider Practice Location Address
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Address Line | 4190 24TH AVE SUITE 206
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City | FORT GRATIOT
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State | MI
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Zip | 48059-3882
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Country | US
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Telephone | 810-989-7478
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Fax | 810-989-7644
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Provider Business Mailing Address
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Address Line | PO BOX 610669
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City | PORT HURON
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State | MI
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Zip | 48061-0669
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Country | US
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Telephone | 810-985-1884
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Fax | 810-966-3025
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 4301103403
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License Number State | MI
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