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NPI Code Detail

MEDICARE: MANIK KUMAR GUPTA

MEDICARE: MANIK KUMAR GUPTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician63104AZ
2207L00000XAnesthesiology PhysicianCDR.0006114CO

General Provider Information

NPI Number : 1548655681
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANIK KUMAR GUPTA
Provider Business Mailing Address
First Line : 3800 WOODWARD AVE APT 704
Second Line :
City : DETROIT
State : MI
Zip : 48201-1980
Country : US
Telephone Number : 404-805-3042
Fax Number :
Provider Business Practice Location Address
First Line : 2601 E ROOSEVELT ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85008-4973
Country : US
Telephone Number : 602-344-5011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2015
Last Update Date : 12/11/2025

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Directions to “ MANIK KUMAR GUPTA ” Practice Location

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