Provider Demographics
NPI:1962660480
Name:GUPTA, NEERAJANA (MBBS)
Entity type:Individual
Prefix:DR
First Name:NEERAJANA
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-9000
Mailing Address - Fax:
Practice Address - Street 1:347 SMITH AVE N STE 203
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2388
Practice Address - Country:US
Practice Address - Phone:651-241-7733
Practice Address - Fax:651-241-7798
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI52288207V00000X
MN64843207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI401600055Medicare Oscar/Certification