Provider Demographics
NPI:1841391570
Name:GUPTA, SATHY (MD)
Entity Type:Individual
Prefix:DR
First Name:SATHY
Middle Name:
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FREEDOM WAY (237)
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-6285
Mailing Address - Country:US
Mailing Address - Phone:706-823-2236
Mailing Address - Fax:706-823-3957
Practice Address - Street 1:1 FREEDOM WAY (237)
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-6285
Practice Address - Country:US
Practice Address - Phone:706-823-2236
Practice Address - Fax:706-823-3957
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010343482085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology