Provider Demographics
NPI:1669751921
Name:GUPTA, RUCHI (MD)
Entity type:Individual
Prefix:DR
First Name:RUCHI
Middle Name:
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 1:440 TAYLOR RD
Mailing Address - Street 2:SUITE 3380
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3588
Mailing Address - Country:US
Mailing Address - Phone:334-213-6287
Mailing Address - Fax:334-213-6288
Practice Address - Street 1:440 TAYLOR RD
Practice Address - Street 2:SUITE 3380
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3588
Practice Address - Country:US
Practice Address - Phone:334-213-6287
Practice Address - Fax:334-213-6288
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL31101208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist