Provider Demographics
NPI:1619650306
Name:GUPTA, RAJUL (MBBS, MS)
Entity Type:Individual
Prefix:DR
First Name:RAJUL
Middle Name:
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MBBS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVENUE, DEPT. OF ORTHOPEDICS
Mailing Address - Street 2:MODULE C,FLOOR 3,SUITE 100 CINCINNATI CHILDRENS HOSPITA
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229
Mailing Address - Country:US
Mailing Address - Phone:240-899-3293
Mailing Address - Fax:
Practice Address - Street 1:3333 BURNET AVENUE, DEPT. OF ORTHOPEDICS
Practice Address - Street 2:MODULE C,FLOOR 3,SUITE 100 CINCINNATI CHILDRENS HOSPITA
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229
Practice Address - Country:US
Practice Address - Phone:513-803-8667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.255723390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program