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NPI Profile for Dr SHIVANE K GUPTA in LILBURN, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oral & Maxillofacial Surgery |
204E00000X | 02 | Physician/General Surgery |
| NPI # | 1295046399 |
|
| Status | Active | |
| Credentials | MD | |
| Entity | Individual | |
| Enumeration date | 06/24/2010 | |
| Last updated | 07/06/2022 - About 4 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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SHIVANE K GUPTA
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SHIVANE K GUPTA, MD