MEDICARE: DR. ANJALI GUPTA MD

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
1	207R00000X	Internal Medicine Physician	53015	MN
2	207R00000X	Internal Medicine Physician	ME156826	FL
3	207R00000X	Internal Medicine Physician	0101246997	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922265123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANJALI GUPTA MD

Provider Business Mailing Address
First Line	:	PO BOX 746636
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6636
Country	:	US
Telephone Number	:	904-202-2092
Fax Number	:	904-376-4075

Provider Business Practice Location Address
First Line	:	98 NOCATEE VILLAGE DR
Second Line	:
City	:	PONTE VEDRA
State	:	FL
Zip	:	32081-6152
Country	:	US
Telephone Number	:	904-202-4243
Fax Number	:	904-390-7415

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2008
Last Update Date	:	12/16/2025

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