Provider Demographics
NPI:1710173943
Name:GUPTA, RASNA (MD)
Entity Type:Individual
Prefix:DR
First Name:RASNA
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:RASNA
Other - Middle Name:HARPREET KAUR
Other - Last Name:MINHAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4201 SAINT ANTOINE ST
Mailing Address - Street 2:2E-UHC
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2153
Mailing Address - Country:US
Mailing Address - Phone:519-890-0566
Mailing Address - Fax:519-250-4401
Practice Address - Street 1:4201 SAINT ANTOINE ST
Practice Address - Street 2:2E-UHC
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2153
Practice Address - Country:US
Practice Address - Phone:519-890-0566
Practice Address - Fax:519-250-4401
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301085803174400000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No174400000XOther Service ProvidersSpecialist