| Shalini Gupta, M.D., P.C. | |
|
25500 Goddard Rd Taylor MI 48180-3926 | |
| (313) 292-1300 | |
| (313) 292-1305 |
| Full Name | Shalini Gupta, M.D., P.C. |
|---|---|
| Speciality | Internal Medicine |
| Location | 25500 Goddard Rd, Taylor, Michigan |
| Authorized Official Name and Position | Corinne Johnson (OFFICE MANAGER) |
| Authorized Official Contact | 3132927700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shalini Gupta, M.D., P.C. 47753 Seven Mile Rd Northville MI 48167 Ph: (248) 842-3221 | Shalini Gupta, M.D., P.C. 25500 Goddard Rd Taylor MI 48180-3926 Ph: (313) 292-1300 |
| NPI Number | 1578583472 |
|---|---|
| Provider Enumeration Date | 07/20/2006 |
| Last Update Date | 12/28/2009 |
| Medicare PECOS PAC ID | 3375556848 |
|---|---|
| Medicare Enrollment ID | O20060731000022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578583472 | NPI | - | NPPES |
| 4264114 TYPE 10 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301067982 (Michigan) | Primary |
| Provider Name | Harvey Minkin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083667430 PECOS PAC ID: 9234197138 Enrollment ID: I20041223000118 |
| Provider Name | Shalini Gupta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467496141 PECOS PAC ID: 2668485137 Enrollment ID: I20060731000014 |
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