Provider Demographics
NPI:1699966556
Name:GUPTA, ANJALI LALA (MD)
Entity type:Individual
Prefix:DR
First Name:ANJALI
Middle Name:LALA
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 1:1309 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1005
Mailing Address - Country:US
Mailing Address - Phone:336-544-5400
Mailing Address - Fax:336-544-5401
Practice Address - Street 1:1309 N ELM ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1005
Practice Address - Country:US
Practice Address - Phone:336-544-5400
Practice Address - Fax:336-544-5401
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200100143207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine