| Doctor Name: | DR. MANISH R GUPTA |
| NPI Number: | 1124005863 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | 35-07-6763-G |
| Business Practice Address: | 1050 Isaac Streets Dr Suite 136 Oregon, OH - 436163291 |
| Business Phone Number: | 4196965656 |
| Business Fax Number: | 4198448784 |
| Mailing Address: | 1050 Isaac Streets Dr, Suite 136 OREGON |
| State: | OH |
| Postal Code: | 436163291 |
| Phone Number: | 4196965656 |
| Fax Number: | 4198448784 |
| NPI Enumeration Date: | 12/23/2005 |
| NPI Last Update Date: | 02/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0122X |
| License Number: | 35-07-6763-G |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Plastic and Reconstructive Surgery |
| Taxonomy Definition: | A surgeon who specializes in plastic and reconstructive surgery. |