Provider Demographics
NPI:1740424001
Name:GUPTA, RASHIM K (MD)
Entity Type:Individual
Prefix:
First Name:RASHIM
Middle Name:K
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 610669
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48061-0669
Mailing Address - Country:US
Mailing Address - Phone:810-985-1884
Mailing Address - Fax:810-966-3025
Practice Address - Street 1:4190 24TH AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:FORT GRATIOT
Practice Address - State:MI
Practice Address - Zip Code:48059-3882
Practice Address - Country:US
Practice Address - Phone:810-989-7478
Practice Address - Fax:810-989-7644
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301103403207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism