Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 35126707 | OH |
Y | 208D00000X | General Practice Physician | 35126707 | OH |
NPI | 1295178382 |
---|---|
Provider Name | Anshuli Gupta |
First Address | Columbus, OH 43214-3908 |
Second Address | Columbus, OH 43214-3908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2013 |
Last Update Date | 02/02/2018 |