Provider Demographics
NPI:1932181989
Name:GUPTA, RASHMI (MD)
Entity Type:Individual
Prefix:DR
First Name:RASHMI
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 1:29592 NORTHWESTERN HWY
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1019
Mailing Address - Country:US
Mailing Address - Phone:248-354-0967
Mailing Address - Fax:248-354-6614
Practice Address - Street 1:29592 NORTHWESTERN HWY
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1019
Practice Address - Country:US
Practice Address - Phone:248-354-0967
Practice Address - Fax:248-354-6614
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010483012084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI383372860OtherCOMMERCIAL
MI3393108-10Medicaid
MI3506328391OtherBCBS
MI3506328391OtherBCBS
E38498Medicare UPIN