Provider Demographics
NPI:1326329673
Name:GUPTA, DEVYANI (MD)
Entity Type:Individual
Prefix:DR
First Name:DEVYANI
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35240 NANKIN BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-7218
Mailing Address - Country:US
Mailing Address - Phone:734-427-3636
Mailing Address - Fax:734-427-3636
Practice Address - Street 1:35240
Practice Address - Street 2:NANKIN BLVD
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185
Practice Address - Country:US
Practice Address - Phone:734-427-3636
Practice Address - Fax:734-427-1483
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-31
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301098995208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics