Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 4301102279 | MI |
N | 207RA0201X | Internist - Allergy & Immunology | 4301102279 | MI |
NPI | 1184886152 |
---|---|
Provider Name | Dr. Dave S Gupta |
First Address | Lansing, MI 48911-4214 |
Second Address | Lansing, MI 48911-4214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2008 |
Last Update Date | 21/03/2018 |