Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | POD000958 | GA |
NPI | 1003810623 |
---|---|
Provider Name | Dr. Rupal Patel Gupta |
First Address | Cumming, GA 30041-7373 |
Second Address | Suwanee, GA 30024-6048 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2005 |
Last Update Date | 30/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
226592810 | UHC (01) | GA |
260427 | COVENTRY (01) | GA |
52026903 | BCBS (01) | GA |
5363600001 | CIGNA DME (01) | GA |
7305891 | CIGNA (01) | GA |
7540578 | AETNA (01) | GA |
948040303D | (05) | GA |
U94009 | (02) | GA |