Provider Demographics
NPI:1023285988
Name:GUPTA, PREEYA KSHETTRY (MD)
Entity type:Individual
Prefix:
First Name:PREEYA
Middle Name:KSHETTRY
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9650 BRIER CREEK PKWY STE 103
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-6504
Mailing Address - Country:US
Mailing Address - Phone:919-391-7224
Mailing Address - Fax:
Practice Address - Street 1:9650 BRIER CREEK PKWY STE 103
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-6504
Practice Address - Country:US
Practice Address - Phone:919-391-7224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC141800207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology