Ravi Gupta,m.d.,s.c. | |
10625 W North Ave Ste 230 Wauwatosa WI 53226-2315 | |
(414) 475-5800 | |
(414) 475-5825 |
Full Name | Ravi Gupta,m.d.,s.c. |
---|---|
Speciality | Family Medicine |
Location | 10625 W North Ave Ste 230, Wauwatosa, Wisconsin |
Authorized Official Name and Position | Ravi Gupta (PRESIDENT) |
Authorized Official Contact | 4144755800 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Ravi Gupta,m.d.,s.c. 10625 W North Ave Ste 230 Wauwatosa WI 53226-2315 Ph: (414) 475-5800 | Ravi Gupta,m.d.,s.c. 10625 W North Ave Ste 230 Wauwatosa WI 53226-2315 Ph: (414) 475-5800 |
NPI Number | 1750547758 |
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Provider Enumeration Date | 07/30/2008 |
Last Update Date | 07/30/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750547758 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 20918 (Wisconsin) | Primary |
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