Individual
MADAN UPRETY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12359 SUNRISE VALLEY DR STE 320, RESTON, VA 20191-3463
(703) 596-4796
Mailing address
12359 SUNRISE VALLEY DR STE 320, RESTON, VA 20191-3463
(703) 596-4796
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101246930
VA
2084P0800X
Psychiatry Physician
48144
WI
2084P0800X
Psychiatry Physician
D0068401
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34667100
—
WI
Enumeration date
02/09/2007
Last updated
02/23/2022
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