Provider Demographics
NPI:1184886152
Name:GUPTA, DAVE S (MD)
Entity type:Individual
Prefix:DR
First Name:DAVE
Middle Name:S
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4265 FIVE OAKS DR
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-4214
Mailing Address - Country:US
Mailing Address - Phone:517-484-2261
Mailing Address - Fax:517-484-6666
Practice Address - Street 1:4265 FIVE OAKS DR
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-4214
Practice Address - Country:US
Practice Address - Phone:517-484-2261
Practice Address - Fax:517-484-6666
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2018-03-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301102279207RA0201X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology