Individual
DR. SURESH C GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3503 PERRY ST, MOUNT RAINER, MD 20712
(301) 864-1133
(301) 864-2155
Mailing address
3503 PERRY ST, MOUNT RAINIER, MD 20712
(301) 864-1133
(301) 864-2155
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
D14876
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0177201400
—
MD
Enumeration date
10/13/2006
Last updated
07/08/2007
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