Individual
PRABHA UGALAT GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
700 24TH ST, FORT LEE, VA 23801-1716
(804) 734-9993
(877) 874-1008
Mailing address
700 24TH ST, FORT LEE, VA 23801-1716
(804) 734-9993
(877) 874-1008
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101237185
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010203121
—
VA
01
—
185140
ANTHEM
—
Enumeration date
04/04/2006
Last updated
04/10/2025
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