Doctor Name: | DR. ATUL MOHAN GUPTA |
NPI Number: | 1427030212 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 23765 |
Business Practice Address: | 55a Sheridan Park Cir Bluffton, SC - 299106025 |
Business Phone Number: | 8438365111 |
Business Fax Number: | 8438365112 |
Mailing Address: | 1694 Old Towne Road, CHARLESTON |
State: | SC |
Postal Code: | 294075045 |
Phone Number: | 8435713100 |
Fax Number: | 8437667798 |
NPI Enumeration Date: | 11/17/2005 |
NPI Last Update Date: | 01/20/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 23765 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | SC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |