Organization
CHHAVI GUPTA, M.D. PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHHAVI GUPTA M.D. (SOLE PROPRIETOR)
(703) 267-5752
Entity
Organization
Contact information
Practice address
2841 HARTLAND RD, SUITE 405, FALLS CHURCH, VA 22043-3500
(703) 267-5752
(703) 621-3786
Mailing address
9181 TOPAZ ST, FAIRFAX, VA 22031-1344
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101249449
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101249449
MEDICAL LICENSE
VA
Enumeration date
03/05/2012
Last updated
03/05/2012
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