Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. SHIVANE K GUPTA, MD
Active Sole ProprietorDR. SHIVANE K GUPTA, MD is a Oral & Maxillofacial Surgery (Physician) healthcare provider located in LILBURN, Georgia. NPI 1295046399 is currently active in the NPPES registry. Verify at CMS.
Oral & Maxillofacial Surgery (Physician) · LILBURN, GA
Registration Details
- NPI Number
- 1295046399
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 24, 2010 (16.170098133094 yrs)
- Last Updated
- Jul 6, 2022
- License
-
078309 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4150 FIVE FORKS TRICKUM RD SW STE 1LILBURN, GA, 300473130Browse GA providers · Browse ZIP 30047
- Phone
- 7707177225
- Fax
- 7707177228
- Primary Specialty
-
Oral & Maxillofacial Surgery (Physician)
204E00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.