Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 267619 | NY |
N | 208000000X | Pediatrician | 4301113493 | MI |
N | 208000000X | Pediatrician | D0072908 | MD |
N | 2080P0201X | Pediatric Allergist | 267619 | NY |
Y | 2080P0201X | Pediatric Allergist | 4301113493 | MI |
NPI | 1467618520 |
---|---|
Provider Name | Dr. Malika Gupta |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48105-9484 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2008 |
Last Update Date | 08/09/2017 |