Provider Demographics
NPI:1447234323
Name:GUPTA, ASHOK K (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:K
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:610 E 12 MILE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-2567
Mailing Address - Country:US
Mailing Address - Phone:248-541-9111
Mailing Address - Fax:248-541-9113
Practice Address - Street 1:610 E 12 MILE RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-2567
Practice Address - Country:US
Practice Address - Phone:248-541-9111
Practice Address - Fax:248-541-9113
Is Sole Proprietor?:No
Enumeration Date:2005-12-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIAG038154207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology