Individual
DR. SUNIL GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19415 DEERFIELD AVE, SUITE 303, LEESBURG, VA 20176-8472
(703) 297-4865
(703) 858-7740
Mailing address
19415 DEERFIELD AVE, STE 303, LEESBURG, VA 20176-8472
(703) 297-4865
(703) 858-7740
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101038914
VA
2080N0001X
Neonatal-Perinatal Medicine Physician
0101038914
VA
208D00000X
General Practice Physician
0101038914
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659357523
—
VA
Enumeration date
12/21/2005
Last updated
03/16/2016
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