Provider Demographics
NPI:1396129607
Name:GUPTA, VRITTI (MD)
Entity type:Individual
Prefix:
First Name:VRITTI
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 1:4550 COBB PARKWAY NORTH NW STE 210
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-4182
Mailing Address - Country:US
Mailing Address - Phone:770-422-1372
Mailing Address - Fax:770-999-2617
Practice Address - Street 1:4550 COBB PARKWAY NORTH NW STE 210
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-4182
Practice Address - Country:US
Practice Address - Phone:770-422-1372
Practice Address - Fax:770-999-2617
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301504474207R00000X, 207RP1001X
GA97816207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine