Individual provider · NPI-1

Anu Gupta, OD

Optometrist · Southfield, MI

NPI number1679304828
StatusActive
Last updated in NPPESAug 9, 2024

Details

NPI
1679304828
Entity type
Individual (NPI-1)
Name
Anu Gupta
Credential
OD
Sex
Female
Sole proprietor
No
Enumeration date
Aug 9, 2024
Certification date
Aug 9, 2024
Last updated
Aug 9, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X Optometrist4901005826MIYes

Practice location

29157 Southfield Rd
Southfield, MI 48076-1900

Phone 248-234-9200

Mailing address

2358 Dorchester Dr N Apt 201
Troy, MI 48084-3735

Phone 407-342-1500

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