Individual
DR. GHANSHYAM GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
10110 MOLECULAR DR STE 111, ROCKVILLE, MD 20850-7538
(301) 838-4224
(301) 838-4244
Mailing address
PO BOX 60410, POTOMAC, MD 20859-0410
(301) 838-4224
(301) 838-4244
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
D0046398
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026309900
—
DC
05
—
407274000
—
MD
01
—
53363801
BC.BS.
MD
01
—
B0750001
BC.BS.
DC
Enumeration date
08/31/2006
Last updated
02/23/2017
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