Provider Demographics
NPI:1265668453
Name:GUPTA, RUCHIR (MD)
Entity Type:Individual
Prefix:DR
First Name:RUCHIR
Middle Name:
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 E HIGHLAND AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4874
Mailing Address - Country:US
Mailing Address - Phone:602-767-0007
Mailing Address - Fax:602-767-0027
Practice Address - Street 1:2222 E HIGHLAND AVE STE 110
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4874
Practice Address - Country:US
Practice Address - Phone:602-767-0007
Practice Address - Fax:602-767-0027
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ60282208VP0000X, 207LP2900X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine