Individual
ASHEESH GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.P.H.
Contact information
Practice address
14605 POTOMAC BRANCH DR, SUITE 300, WOODBRIDGE, VA 22191-3336
(703) 490-1112
Mailing address
14605 POTOMAC BRANCH DR, SUITE 300, WOODBRIDGE, VA 22191-3336
(703) 490-1112
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
0101256548
VA
Other
Enumeration date
05/13/2007
Last updated
10/04/2022
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