Individual
PRANAY GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3660 BOULEVARD, COLONIAL HEIGHTS, VA 23834-1345
(804) 243-2020
(804) 754-1428
Mailing address
809 CLUB RIDGE CT, CHESTER, VA 23836-2745
(804) 243-2020
(804) 754-1428
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101230970
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6304559
—
VA
Enumeration date
05/31/2006
Last updated
04/04/2008
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