Individual
ARCHANA GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
22590 SHADY CT, CALIFORNIA, MD 20619-5009
(301) 373-7900
(301) 373-6900
Mailing address
PO BOX 640, HOLLYWOOD, MD 20636-0640
(301) 373-7318
(301) 373-6900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
S0056261
MD
207QA0000X
Adolescent Medicine (Family Medicine) Physician
D0056261
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080160592
MEDICARE RAILROAD
MD
05
—
291106000
—
MD
Enumeration date
07/17/2006
Last updated
09/13/2021
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